{
  "hospital_name": "Dublin Methodist Hospital",
  "last_updated_on": "2025-01-22",
  "version": "2.2.0",
  "hospital_location": [
    "Dublin Methodist Hospital"
  ],
  "hospital_address": [
    "7500 Hospital Dr, Dublin, OH 43016"
  ],
  "license_information": {
    "license_number": "360017",
    "state": "OH"
  },
  "affirmation": {
    "affirmation": "To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.",
    "confirm_affirmation": true
  },
  "standard_charge_information": [
    {
      "description": "Catheter Silicone Elastomer 16 Fr 5 Cc Peco Cardinal",
      "code_information": [
        {
          "code": "PX-CH-PCPF6516",
          "type": "CDM"
        },
        {
          "code": "A4338",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.33,
          "discounted_cash": 0.86,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter Silicone Elastomer 20 Fr 30 Cc Peco Cardinal",
      "code_information": [
        {
          "code": "PX-CH-PCPF6620",
          "type": "CDM"
        },
        {
          "code": "A4338",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.37,
          "discounted_cash": 0.89,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.89
            }
          ]
        }
      ]
    },
    {
      "description": "Alginate Calcium Melgisorb Pls 4 in X 8 In",
      "code_information": [
        {
          "code": "PX-CH-SM251500",
          "type": "CDM"
        },
        {
          "code": "A6197",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.57,
          "discounted_cash": 6.22,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.13
            }
          ]
        }
      ]
    },
    {
      "description": "Adhesive Remover Wipe Uni-Solve",
      "code_information": [
        {
          "code": "PX-CH-UN4023-00",
          "type": "CDM"
        },
        {
          "code": "A4456",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.32,
          "discounted_cash": 0.21,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Thermometer Digital Oral Cardinal Health Brand 60sec",
      "code_information": [
        {
          "code": "PX-CH-A1-16811EDS",
          "type": "CDM"
        },
        {
          "code": "A4931",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.87,
          "discounted_cash": 6.42,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.09
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.21
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8.69
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.21
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.39
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.87,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.48
            }
          ]
        }
      ]
    },
    {
      "description": "Washcloth Disposable 3.2% Dimethicone",
      "code_information": [
        {
          "code": "PX-CH-A1-2AWU42",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.1,
          "discounted_cash": 0.06,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.08
            }
          ]
        }
      ]
    },
    {
      "description": "Therm Probe Covers Electronic Fits Sure Temp A1-W01690200",
      "code_information": [
        {
          "code": "PX-CH-A1-WA05031750",
          "type": "CDM"
        },
        {
          "code": "A4649",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.14,
          "discounted_cash": 0.09,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.12
            }
          ]
        }
      ]
    },
    {
      "description": "\"Underpad 30\"\" X 36\"\"\"",
      "code_information": [
        {
          "code": "PX-CH-AHPASB3036",
          "type": "CDM"
        },
        {
          "code": "A4554",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 41.36,
          "discounted_cash": 26.88,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 27.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 34.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 26.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 33.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.14
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.14
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 36.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 41.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 36.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 33.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 34.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 34.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.19
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 36.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31.02
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 11.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.75
            }
          ]
        }
      ]
    },
    {
      "description": "Blood Transfer Device Female Adapter",
      "code_information": [
        {
          "code": "PX-CH-BD364880",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.48,
          "discounted_cash": 0.96,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.94
            }
          ]
        }
      ]
    },
    {
      "description": "\"1 Pc Pre Cut Std Wear Assura 1\"\" Pre-Cut Flat Closed\"",
      "code_information": [
        {
          "code": "PX-CH-CO12134",
          "type": "CDM"
        },
        {
          "code": "A4416",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.47,
          "discounted_cash": 2.91,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.48
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.22
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.87
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.83
            }
          ]
        }
      ]
    },
    {
      "description": "Theraband Orange 6yds Latex Free Level 2",
      "code_information": [
        {
          "code": "PX-CH-EMPI-084",
          "type": "CDM"
        },
        {
          "code": "A9300",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 29.68,
          "discounted_cash": 19.29,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 26.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 29.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.68
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.76
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.23
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.23
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 19.59
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 26.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.32
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 24.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 26.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.47
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 24.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.6
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 29.68,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.23
            }
          ]
        }
      ]
    },
    {
      "description": "Briefs Heavy Absorbency Medium Prevail Pm Extended Wear",
      "code_information": [
        {
          "code": "PX-CH-IMCFQNTB0121",
          "type": "CDM"
        },
        {
          "code": "A4520",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.2,
          "discounted_cash": 0.78,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            }
          ]
        }
      ]
    },
    {
      "description": "Briefs Breezers Prevail Xlarge Cloth-Like Brief",
      "code_information": [
        {
          "code": "PX-CH-IMCFQPVB014",
          "type": "CDM"
        },
        {
          "code": "A4520",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.13,
          "discounted_cash": 0.73,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Matrix Drsg Collagen Ag Reliamed 2 X 2 Colactive",
      "code_information": [
        {
          "code": "PX-CH-IMCXCTWBC1033",
          "type": "CDM"
        },
        {
          "code": "A6021",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 15.56,
          "discounted_cash": 10.11,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.89
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.99
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 10.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.56
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 15.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 13.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.99
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.89
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.56
            }
          ]
        }
      ]
    },
    {
      "description": "Matrix Drsg Collagen Ag Reliamed 4 in X 4 in Colactive",
      "code_information": [
        {
          "code": "PX-CH-IMCXCTWBC1034",
          "type": "CDM"
        },
        {
          "code": "A6021",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 34.71,
          "discounted_cash": 22.56,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 34.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.34
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.52
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 30.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.48
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.77
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 22.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.09
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.52
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.46
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.44
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.26
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.26
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Blood Collection Set 21g X 3/4 in Winged Safety",
      "code_information": [
        {
          "code": "PX-CH-KN225299",
          "type": "CDM"
        },
        {
          "code": "A4215",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.76,
          "discounted_cash": 1.14,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.44
            }
          ]
        }
      ]
    },
    {
      "description": "\"Catheter 2 Way Silver Foley 22 Fr 16\"\" L Silver Coated\"",
      "code_information": [
        {
          "code": "PX-CH-KN605221IC",
          "type": "CDM"
        },
        {
          "code": "A4344",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 28.44,
          "discounted_cash": 18.49,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 21.73
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 23.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 24.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 15.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 23.58
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 21.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 15.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 23.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 21.73
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21.33
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21.33
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.17
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 21.73
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 18.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 23.58
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.17
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 25.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.64
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.51
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 21.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 7.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 15.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 28.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.51
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.64
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 23.01
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 15.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 21.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 24.94
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 28.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.64
            }
          ]
        }
      ]
    },
    {
      "description": "Sharps Container 1 Qt Red",
      "code_information": [
        {
          "code": "PX-CH-KN8900SA",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.04,
          "discounted_cash": 1.98,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.58
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.49
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.67
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.58
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.58
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.49
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 6.05,
          "discounted_cash": 3.93,
          "payers_information": [
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 2.79,
          "discounted_cash": 1.81,
          "payers_information": [
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.29
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.29
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.79,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.79
            }
          ]
        }
      ]
    },
    {
      "description": "Mask Cpr Micro-Shield Tamper Resist Pouch",
      "code_information": [
        {
          "code": "PX-CH-MQ70-155",
          "type": "CDM"
        },
        {
          "code": "A4649",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.69,
          "discounted_cash": 6.3,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.69
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.24
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.24
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.22
            }
          ]
        }
      ]
    },
    {
      "description": "Saline Flush Sterile 0.9% 5ml (12ml Syringe)",
      "code_information": [
        {
          "code": "PX-CH-MT2K0905",
          "type": "CDM"
        },
        {
          "code": "A4223",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.04,
          "discounted_cash": 0.68,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.85
            }
          ]
        }
      ]
    },
    {
      "description": "Lemon Glycerine Insta-Swabstick",
      "code_information": [
        {
          "code": "PX-CH-MZMDS090600",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.19,
          "discounted_cash": 0.12,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Bag Bio-Hazard 12 in X 12 in Red",
      "code_information": [
        {
          "code": "PX-CH-MZNON151212",
          "type": "CDM"
        },
        {
          "code": "CUSTOM",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.26,
          "discounted_cash": 0.17,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter Silicone Elastomer 24 Fr 5 Cc Peco Cardinal",
      "code_information": [
        {
          "code": "PX-CH-PCPF6524",
          "type": "CDM"
        },
        {
          "code": "A4338",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.33,
          "discounted_cash": 0.86,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "\"Cervical Collar Natural 3\"\" Scott Specialties Med 11'- 15\"\"\"",
      "code_information": [
        {
          "code": "PX-CH-SS3005NATMD",
          "type": "CDM"
        },
        {
          "code": "L0120",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.32,
          "discounted_cash": 6.71,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.56
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 31.12,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 32.68,
              "additional_payer_notes": "DMEPOS FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.82
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.56
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.12,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.88
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.32,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.46
            }
          ],
          "minimum": 31.12,
          "maximum": 31.12
        }
      ]
    },
    {
      "description": "Barrier Strip Elastic Brava C Shaped Strip",
      "code_information": [
        {
          "code": "PX-CH-CO120700",
          "type": "CDM"
        },
        {
          "code": "A4362",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.89,
          "discounted_cash": 1.88,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.17
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.17
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.6
            }
          ]
        }
      ]
    },
    {
      "description": "Hydrogel Gel Anacept 3oz",
      "code_information": [
        {
          "code": "PX-CH-ANA5003G",
          "type": "CDM"
        },
        {
          "code": "A6248",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 41.81,
          "discounted_cash": 27.18,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 34.66
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.54
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 36.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 34.66
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 23.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.22
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 33.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 27.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 23.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.42
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 27.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.54
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 36.79
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 23.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 34.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.94
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 23.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.42
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 36.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 41.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 41.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 33.82
            }
          ]
        }
      ]
    },
    {
      "description": "Alcohol Wipes 2-Ply Webcol Medium 1.5 in X 1.5 In",
      "code_information": [
        {
          "code": "PX-CH-KN6818",
          "type": "CDM"
        },
        {
          "code": "A4245",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.01,
          "discounted_cash": 0.01,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.01
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 0.02,
          "discounted_cash": 0.01,
          "payers_information": [
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.02
            }
          ]
        }
      ]
    },
    {
      "description": "Gauze Impregnated Dry Sodium Mesalt 3 in X 3 In",
      "code_information": [
        {
          "code": "PX-CH-SM285780",
          "type": "CDM"
        },
        {
          "code": "A6222",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.94,
          "discounted_cash": 1.26,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.94,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.65
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Pouch 2 3/4 in New Image Lock & Roll Closure",
      "code_information": [
        {
          "code": "PX-CH-HO18194",
          "type": "CDM"
        },
        {
          "code": "A4425",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.24,
          "discounted_cash": 1.46,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.24
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.97
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.24
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.96
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.9
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 1.68,
          "discounted_cash": 1.09,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.06
            }
          ]
        }
      ]
    },
    {
      "description": "Tubular Drsg Tubigrip Size E Lg Ankles Med Knees Sm Thighs",
      "code_information": [
        {
          "code": "PX-CH-CV1514-34",
          "type": "CDM"
        },
        {
          "code": "A4649",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8,
          "discounted_cash": 5.2,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.28
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 79.96,
          "discounted_cash": 51.97,
          "payers_information": [
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.97
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 21.83
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 58.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 44.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 59.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 64.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.57
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.97
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 58.37
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.33
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 66.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.33
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 59.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 52.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 61.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.53
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 66.29
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.97
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 52.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 59.97
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.97
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 52.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 44.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 58.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 61.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.53
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 70.36
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 52.05
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.97
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.53
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 52.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 52.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 61.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 58.37
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 44.38
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 79.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 58.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 44.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 61.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.33
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 58.37
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 61.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.97
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 79.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 61.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 51.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 64.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 66.29
            }
          ]
        }
      ]
    },
    {
      "description": "Gloves Vinyl Powder Free Large",
      "code_information": [
        {
          "code": "PX-CH-MZMDS191076",
          "type": "CDM"
        },
        {
          "code": "A4927",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.06,
          "discounted_cash": 0.04,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.06,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "Foam Drsg Adhesive Border Mepilex Sacrum 9 in X 9 In",
      "code_information": [
        {
          "code": "PX-CH-SM282400",
          "type": "CDM"
        },
        {
          "code": "A6213",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 24.34,
          "discounted_cash": 15.82,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.63
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.39
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.96
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.63
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 21.35
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 19.69
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.51
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.6
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.38
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.96
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 16.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.63
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 21.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.63
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 21.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 24.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.63
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 19.69
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.18
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.39
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.6
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.77
            }
          ]
        }
      ]
    },
    {
      "description": "Hydrocolloid Drsg Reliamed 6 in X 7 in Sacral",
      "code_information": [
        {
          "code": "PX-CH-IMCDHC67SB",
          "type": "CDM"
        },
        {
          "code": "A6235",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.57,
          "discounted_cash": 4.92,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.07
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.21
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.93
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter Silicone Elastomer 20 Fr 5 Cc",
      "code_information": [
        {
          "code": "PX-CH-BA123520A",
          "type": "CDM"
        },
        {
          "code": "A4338",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.28,
          "discounted_cash": 0.83,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 1.26,
          "discounted_cash": 0.82,
          "payers_information": [
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.26,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.03
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 2.11,
          "discounted_cash": 1.37,
          "payers_information": [
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.11,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.79
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 3.17,
          "discounted_cash": 2.06,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            }
          ]
        }
      ]
    },
    {
      "description": "Wrap Self-Closure Bandage 6 in Econo-Fix",
      "code_information": [
        {
          "code": "PX-CH-HA51600000",
          "type": "CDM"
        },
        {
          "code": "A6450",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.79,
          "discounted_cash": 1.16,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.79,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.34
            }
          ]
        }
      ]
    },
    {
      "description": "1 Pc Ctf Ext Wear Uro Up to 2 1/2 in Premier",
      "code_information": [
        {
          "code": "PX-CH-HO8460",
          "type": "CDM"
        },
        {
          "code": "A4428",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.09,
          "discounted_cash": 3.31,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.09,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 10.27,
          "discounted_cash": 6.68,
          "payers_information": [
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.69
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.69
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.31
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.27,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Compression System Coban 2 Layer Lite",
      "code_information": [
        {
          "code": "PX-CH-3M2794",
          "type": "CDM"
        },
        {
          "code": "A6454",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 29.89,
          "discounted_cash": 19.43,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 26.21
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.41
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.41
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 26.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.19
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.41
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 22.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.51
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 22.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.59
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 19.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.59
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 8.16
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.44
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 24.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.84
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.19
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 26.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.46
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.89
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 24.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.51
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.41
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 22.42
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.51
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 29.89,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.41
            }
          ]
        }
      ]
    },
    {
      "description": "Attachment Device Foley Stat Lock (Silicone)",
      "code_information": [
        {
          "code": "PX-CH-FOL0100",
          "type": "CDM"
        },
        {
          "code": "A4333",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.52,
          "discounted_cash": 4.24,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.62
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.59
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.59
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.52,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 7.45,
          "discounted_cash": 4.84,
          "payers_information": [
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "Non-Adherent Drsg Sterile Telfa 3 in X 4 In",
      "code_information": [
        {
          "code": "PX-CH-KN2132",
          "type": "CDM"
        },
        {
          "code": "A6402",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.24,
          "discounted_cash": 0.16,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.24,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Ctf Ext Wear 3/8 in - 2 3/4 in Assura Yello",
      "code_information": [
        {
          "code": "PX-CH-SW14306",
          "type": "CDM"
        },
        {
          "code": "A4410",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 16.04,
          "discounted_cash": 10.43,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.3
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.9
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.3
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 16.04
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 14.12
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.14
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 10.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.04,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Foam Drsg Non-Adhesive Mepilex Lite 4 in X 4 In",
      "code_information": [
        {
          "code": "PX-CH-SM284190",
          "type": "CDM"
        },
        {
          "code": "A6209",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.09,
          "discounted_cash": 0.06,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.05
            }
          ]
        }
      ]
    },
    {
      "description": "Underpad 30 in X 30 in Moderate Absorbency Cardinal",
      "code_information": [
        {
          "code": "PX-CH-IMCGR3030",
          "type": "CDM"
        },
        {
          "code": "T4541",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.43,
          "discounted_cash": 0.28,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Patient Repositioning Device Sally Slide Bariatric Size",
      "code_information": [
        {
          "code": "PX-CH-BUR-5848S",
          "type": "CDM"
        },
        {
          "code": "E0705",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 40.69,
          "discounted_cash": 26.45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 40.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.37
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 32.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33.73
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.59
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 26.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 35.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30.52
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 35.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 32.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.12
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 11.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.59
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 26.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 35.69
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.59
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 40.69,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.72
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.37
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter External All Silicone Intermediate 31mm Freedom",
      "code_information": [
        {
          "code": "PX-CH-MN5300",
          "type": "CDM"
        },
        {
          "code": "A4349",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.15,
          "discounted_cash": 1.4,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.89
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Gait Belt 60 in Heavy Web W/Buckle",
      "code_information": [
        {
          "code": "PX-CH-SC530-60",
          "type": "CDM"
        },
        {
          "code": "E0700",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11.66,
          "discounted_cash": 7.58,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.75
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 7.58
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.56
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 10.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 11.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.66,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.41
            }
          ]
        }
      ]
    },
    {
      "description": "Attachment Device Foley Leg Strap Latex Free",
      "code_information": [
        {
          "code": "PX-CH-DL316",
          "type": "CDM"
        },
        {
          "code": "A4334",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.23,
          "discounted_cash": 4.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.23
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.57
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.28
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.97
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.93
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.28
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.23,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Tape Paper Micropore 3 in X 10 Yds",
      "code_information": [
        {
          "code": "PX-CH-3M1530-3",
          "type": "CDM"
        },
        {
          "code": "A4450",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.8,
          "discounted_cash": 1.17,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.8
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Briefs Wings Adult 2x-Large",
      "code_information": [
        {
          "code": "PX-CH-KN67093",
          "type": "CDM"
        },
        {
          "code": "T4524",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.46,
          "discounted_cash": 0.95,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.46,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.12
            }
          ]
        }
      ]
    },
    {
      "description": "Washcloth Easi Cleanse Self Foaming Bedside Care",
      "code_information": [
        {
          "code": "PX-CH-CO7055",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.45,
          "discounted_cash": 0.29,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Interdry Ag 10 in X 144 In",
      "code_information": [
        {
          "code": "PX-CH-CO7910",
          "type": "CDM"
        },
        {
          "code": "A6250",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 107.15,
          "discounted_cash": 69.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 93.97
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.08
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 80.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 86.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 29.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 80.36
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 59.47
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 93.97
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 88.83
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 94.29
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.86
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 86.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.08
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.72
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 70.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 88.83
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 107.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 88.83
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 59.47
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 59.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 80.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 59.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.22
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.72
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.08
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.22
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 107.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Heel Protector With Kodel",
      "code_information": [
        {
          "code": "PX-CH-HE8210",
          "type": "CDM"
        },
        {
          "code": "E0191",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11,
          "discounted_cash": 7.15,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.12
            }
          ]
        }
      ]
    },
    {
      "description": "HC Fsed Comprehensive Metabolic Panel",
      "code_information": [
        {
          "code": "PX-30101199",
          "type": "CDM"
        },
        {
          "code": "80053",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 74,
          "discounted_cash": 48.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 64.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.17
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 74,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 61.35
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.6,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 40.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 20.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 56.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.51
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 10.56,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 11.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.6,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 40.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 56.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 64.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.6,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.6,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.17
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 74,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 59.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 60.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 60.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.6,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 40.7
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 74,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.6,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.6,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 41.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 41.07
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 48.1
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 65.12
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.9
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 60.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.6,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 48.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 41.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 40.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.45,
              "estimated_amount": 15.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.51
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.9
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 60.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 60.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.6,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 40.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.6,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.6,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.6,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.6,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.45,
              "estimated_amount": 15.45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.45,
              "estimated_amount": 15.45
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.6,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 56.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 59.87
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 56.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 56.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 56.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 61.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.6,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 40.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 61.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 40.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 41.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.6,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.6,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 60.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 60.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.56,
              "estimated_amount": 10.56
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 60.68
            }
          ],
          "minimum": 10.56,
          "maximum": 39.6
        }
      ]
    },
    {
      "description": "HC Fsed Occult Blood Stool",
      "code_information": [
        {
          "code": "PX-30101205",
          "type": "CDM"
        },
        {
          "code": "82270",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 72,
          "discounted_cash": 46.8,
          "minimum": 4.38,
          "maximum": 16.43,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.36,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.7,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.36,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.8,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.08,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.36,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.36,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.36,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 46.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 36
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 25,
              "estimated_amount": 18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 32.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.08,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 32.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.56
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.08,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.04
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 32.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 32.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 32.4
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.8,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.36,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 47.52
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.08,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.08,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 36
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.36,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 72,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.04
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.7,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 63.36
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.56
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.56
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 36
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.36,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 32.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.36,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.36,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.8,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 72,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.36,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 32.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.7,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 72,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.36,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.7,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.08,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 32.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 32.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 32.4
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 4.38,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 4.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 36
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.38,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.2
            }
          ]
        }
      ]
    },
    {
      "description": "Fsed Glutamyltransferase Gamma Ggt",
      "code_information": [
        {
          "code": "PX-30101212",
          "type": "CDM"
        },
        {
          "code": "82977",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 51,
          "discounted_cash": 33.15,
          "minimum": 5.92,
          "maximum": 27,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.75,
              "estimated_amount": 14.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.18,
              "estimated_amount": 14.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.75,
              "estimated_amount": 14.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27,
              "estimated_amount": 27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27,
              "estimated_amount": 27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27,
              "estimated_amount": 27
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.52,
              "estimated_amount": 10.52
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.52,
              "estimated_amount": 10.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.75,
              "estimated_amount": 14.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.75,
              "estimated_amount": 14.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.18,
              "estimated_amount": 14.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.75,
              "estimated_amount": 14.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.23
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27,
              "estimated_amount": 27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.75,
              "estimated_amount": 14.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.18,
              "estimated_amount": 14.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 41.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 25.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 25.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27,
              "estimated_amount": 27
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.23
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 25,
              "estimated_amount": 12.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27,
              "estimated_amount": 27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27,
              "estimated_amount": 27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.92,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.92,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 25.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 41.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27,
              "estimated_amount": 27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.23
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 25.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27,
              "estimated_amount": 27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27,
              "estimated_amount": 27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.75,
              "estimated_amount": 14.75
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27,
              "estimated_amount": 27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.92,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 7.2,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 7.56,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 38.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.18,
              "estimated_amount": 14.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27,
              "estimated_amount": 27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 25.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27,
              "estimated_amount": 27
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 44.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.18,
              "estimated_amount": 14.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 25.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 33.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.92,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 25.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.75,
              "estimated_amount": 14.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 41.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.75,
              "estimated_amount": 14.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 25.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 41.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 41.82
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.75,
              "estimated_amount": 14.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 41.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 41.82
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 41.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27,
              "estimated_amount": 27
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 25.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.18,
              "estimated_amount": 14.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.75,
              "estimated_amount": 14.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.23
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 25.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.75,
              "estimated_amount": 14.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 45,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27,
              "estimated_amount": 27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.05
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27,
              "estimated_amount": 27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 27,
              "estimated_amount": 27
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.52,
              "estimated_amount": 10.52
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.2,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.05
            }
          ]
        }
      ]
    },
    {
      "description": "HC Fsed Ast Sgot",
      "code_information": [
        {
          "code": "PX-30101220",
          "type": "CDM"
        },
        {
          "code": "84450",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10,
          "discounted_cash": 6.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.55,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.29
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.55,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.55,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 5.18,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5.44,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.18,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.43,
              "estimated_amount": 19.43
            }
          ],
          "minimum": 5.18,
          "maximum": 19.43
        }
      ]
    },
    {
      "description": "HC Fsed Troponin Quantitative",
      "code_information": [
        {
          "code": "PX-30101222",
          "type": "CDM"
        },
        {
          "code": "84484",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 92,
          "discounted_cash": 59.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 76.27
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 92,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 80.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.38,
              "estimated_amount": 14.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 51.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 51.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 80.68
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 12.47,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 13.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 51.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 51.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 76.27
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.16
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 92,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 74.43
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.38,
              "estimated_amount": 14.38
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.38,
              "estimated_amount": 14.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.16
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.16
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.89
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 92,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 80.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 74.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 69
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 60.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 76.27
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 59.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.76,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.14
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 25.12
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.47,
              "estimated_amount": 12.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 92
            }
          ],
          "minimum": 12.47,
          "maximum": 46.76
        }
      ]
    },
    {
      "description": "HC Fsed Hematocrit",
      "code_information": [
        {
          "code": "PX-30500129",
          "type": "CDM"
        },
        {
          "code": "85014",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9,
          "discounted_cash": 5.85,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.89,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.89,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.89,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.89
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.46,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.89,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.89,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.46,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.89,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.89,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.89,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 2.37,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.89,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.89,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.89,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.89,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.89,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.89,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.46,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.37,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.89,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.89,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.89,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9,
              "additional_payer_notes": "OUTPATIENT"
            }
          ],
          "minimum": 2.37,
          "maximum": 8.89
        }
      ]
    },
    {
      "description": "HC Kras Gene Addl Variants So",
      "code_information": [
        {
          "code": "PX-30101225",
          "type": "CDM"
        },
        {
          "code": "81276",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 683,
          "discounted_cash": 443.95,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 426.88
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 375.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 560.06
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 580.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 134.27,
              "estimated_amount": 134.27
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 201.55,
              "estimated_amount": 201.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 580.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 683,
              "additional_payer_notes": "REFERENCE LAB"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 426.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 512.25
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 601.04
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 512.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 580.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 375.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 443.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 426.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 512.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 560.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 426.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 683,
              "additional_payer_notes": "REFERENCE LAB"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 375.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 683,
              "additional_payer_notes": "REFERENCE LAB"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 580.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 375.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 134.27,
              "estimated_amount": 134.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 341.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 498.59
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 426.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 134.27,
              "estimated_amount": 134.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 426.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 426.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 683,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 498.59
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 580.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 498.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 498.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 341.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 201.55,
              "estimated_amount": 201.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 580.55
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 174.4,
              "estimated_amount": 174.4
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 25,
              "estimated_amount": 170.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 426.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 560.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 683,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 193.25,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 202.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 341.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 560.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 580.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 375.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 683,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 134.27,
              "estimated_amount": 134.27
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 498.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 560.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 426.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 683,
              "additional_payer_notes": "REFERENCE LAB"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 375.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 341.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 683,
              "additional_payer_notes": "REFERENCE LAB"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 580.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 426.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 683,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 341.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 375.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 341.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 580.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 580.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 683,
              "additional_payer_notes": "REFERENCE LAB"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 683,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 683,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 724.69,
              "estimated_amount": 724.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 341.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 580.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 426.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 683,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 683,
              "additional_payer_notes": "Reference Lab"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 580.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.5,
              "estimated_amount": 426.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 341.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 498.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 341.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 560.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 560.06
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 193.25,
              "estimated_amount": 193.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 560.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 50,
              "estimated_amount": 341.5
            }
          ],
          "minimum": 134.27,
          "maximum": 724.69
        }
      ]
    },
    {
      "description": "Ted Stocking Knee High Small/Regular",
      "code_information": [
        {
          "code": "PX-CH-KN7071",
          "type": "CDM"
        },
        {
          "code": "A6530",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11.17,
          "discounted_cash": 7.26,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.93,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.93,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.93,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.93,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.93,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.93,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.15
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.8
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.93,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.93,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.38
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.93,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.93,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 11.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ],
          "minimum": 36.93,
          "maximum": 36.93
        }
      ]
    },
    {
      "description": "HC Ide G150107 Amaze Suture Cutter",
      "code_information": [
        {
          "code": "PX-62400177",
          "type": "CDM"
        },
        {
          "code": "C1889",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 400,
          "discounted_cash": 260,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 340
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 340
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 340
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 222
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 260.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 400,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 400,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 305.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 252.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 400,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 252.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 109.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 252.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 220
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 400,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 220
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 328
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 400,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 340
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 328
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 340
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 292
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 331.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 400,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 340
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 300
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 292
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 222
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 400,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 340
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 340
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 252.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 305.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 300
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 340
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 400,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 400,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 400,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 400,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 400,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 400,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 400,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 252.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 305.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 350.8
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 400,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 260.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 328
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 260.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 340
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 252.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 220
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 292
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 305.6
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 323.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 340
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 340
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 292
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 331.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 328
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 328
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 400,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 400,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 305.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 328
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 400,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 400,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 400,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 340
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 300
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 400
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 340
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 264
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 220
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 292
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 331.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 350.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 328
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 400,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 400,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 305.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 260
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 252.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 260.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 220
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 292
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 252.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 260.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 323.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 328
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 220
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 222
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 400,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 400,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 220
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 222
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 352
            }
          ]
        }
      ]
    },
    {
      "description": "FELBAMATE 600 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-10025",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.75,
          "discounted_cash": 5.04,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.04
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            }
          ]
        }
      ]
    },
    {
      "description": "EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",
      "drug_information": {
        "unit": "0.3",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-100491",
          "type": "CDM"
        },
        {
          "code": "J0171",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1431.95,
          "discounted_cash": 930.77,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1094.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 787.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1431.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1174.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.16
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 390.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 794.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1174.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 904.99
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 787.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1094.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.31
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.31
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 794.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 794.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 932.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 930.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.31
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1174.2
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 313.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1073.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 904.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1094.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.31
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1187.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1045.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1187.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1045.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1174.2
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 904.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 904.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.31
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1174.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 904.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1174.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1045.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1158.45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 904.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1073.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1073.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1045.32
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 904.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 787.57
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1045.32
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1094.01
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 932.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1158.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 932.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 932.2
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 945.09
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.16
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1255.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1174.2
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1174.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1094.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 904.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 787.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 794.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.16
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 932.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 787.57
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1255.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1045.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 787.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1094.01
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.31
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 787.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1187.09
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1431.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1260.12
            }
          ]
        }
      ]
    },
    {
      "description": "FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-10059",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 286.6,
          "discounted_cash": 186.29,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 218.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 218.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 218.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 157.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 159.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 237.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 243.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 209.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 179.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 181.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 251.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 179.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 235.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 181.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 181.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 235.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 179.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 186
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 179.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 243.61
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 243.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 209.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 235.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 186
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 179.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 218.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 157.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 251.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 218.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 181.13
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 189.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 186.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 157.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 235.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 157.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 209.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 157.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 209.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 179.98
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 286.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 179.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 157.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 159.06
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 252.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 181.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 243.61
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 78.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 181.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 231.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 209.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 179.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 243.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 218.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 286.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 243.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 181.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 181.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 186
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 237.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 237.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 235.01
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 214.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 179.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 235.01
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 243.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 186.58
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 243.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 209.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 186.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 179.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 214.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 159.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 235.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 243.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 231.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 179.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 157.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 179.98
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 243.61
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 243.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 179.98
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 186.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 159.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 186.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 186
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 186.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 243.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 235.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 214.95
            }
          ]
        }
      ]
    },
    {
      "description": "GLYCOPYRROLATE 1 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-10130",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.65,
          "discounted_cash": 4.32,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.83
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            }
          ]
        }
      ]
    },
    {
      "description": "BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM",
      "drug_information": {
        "unit": "15",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-1027",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 100.85,
          "discounted_cash": 65.55,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 88.45
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 27.53
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 65.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 65.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73.62
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 100.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 83.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 75.64
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 88.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 83.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 81.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 100.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 65.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 55.97
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 66.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 88.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 75.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 83.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 55.97
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 65.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 55.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 75.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 65.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 55.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 65.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 65.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.47
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.74
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 81.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.33
            }
          ]
        }
      ]
    },
    {
      "description": "KETOCONAZOLE 200 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-10369",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.8,
          "discounted_cash": 4.42,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.64
            }
          ]
        }
      ]
    },
    {
      "description": "LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100,000 INJECTION SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-10430",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 33.7,
          "discounted_cash": 21.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 27.94
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 27.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 29.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 18.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.65
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 22.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.6
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 18.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 27.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 29.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 29.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 21.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 21.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 27.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.63
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 21.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 18.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 21.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 33.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.54
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 18.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 27.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 33.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.3
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 21.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 21.16
            }
          ]
        }
      ]
    },
    {
      "description": "LORAZEPAM 2 MG/ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "0.25",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-10467",
          "type": "CDM"
        },
        {
          "code": "J2060",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 34.3,
          "discounted_cash": 22.29,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.21
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.73
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 30.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.96,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 22.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.96,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.96,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.96,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.96,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.13
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 27.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.96,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 27.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.96,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.96,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.36
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 22.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.96,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.96,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.68
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.68
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.96,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.96,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.96,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.96,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.96,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.13
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.68
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.96,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.96,
              "estimated_amount": 3.96
            }
          ],
          "minimum": 2.25,
          "maximum": 3.96
        }
      ]
    },
    {
      "description": "MERCAPTOPURINE 50 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-10531",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.1,
          "discounted_cash": 5.26,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.2
            }
          ]
        }
      ]
    },
    {
      "description": "CEFEPIME 2 GRAM/50 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK",
      "drug_information": {
        "unit": "50",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-105552",
          "type": "CDM"
        },
        {
          "code": "J0703",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 125.3,
          "discounted_cash": 81.44,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 80.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 79.19
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 82.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 102.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.6,
              "estimated_amount": 55.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.6,
              "estimated_amount": 55.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.33,
              "estimated_amount": 46.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 102.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 109.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 91.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 80.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 93.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 81.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.6,
              "estimated_amount": 55.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 95.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 102.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 80.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 95.73
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.51
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 81.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 81.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.6,
              "estimated_amount": 55.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 80.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.6,
              "estimated_amount": 55.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 80.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 95.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 79.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 93.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 102.75
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 125.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 109.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.33,
              "estimated_amount": 46.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 101.37
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 81.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.6,
              "estimated_amount": 55.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.6,
              "estimated_amount": 55.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 80.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 95.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.51
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 79.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 102.75
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 34.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.6,
              "estimated_amount": 55.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 91.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 103.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 95.73
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.33,
              "estimated_amount": 46.33
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 125.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 125.3,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.6,
              "estimated_amount": 55.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.6,
              "estimated_amount": 55.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.6,
              "estimated_amount": 55.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 95.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 80.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 79.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 81.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 102.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 103.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 81.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.6,
              "estimated_amount": 55.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.33,
              "estimated_amount": 46.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 91.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 103.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 102.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 102.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 101.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.6,
              "estimated_amount": 55.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 80.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 79.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 46.33,
              "estimated_amount": 46.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.6,
              "estimated_amount": 55.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.6,
              "estimated_amount": 55.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 80.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 80.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 91.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 80.44
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 91.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.6,
              "estimated_amount": 55.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 125.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 79.19
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 125.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 79.19
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 110.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 55.6,
              "estimated_amount": 55.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 93.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 79.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 106.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 80.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 91.47
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 125.3,
              "additional_payer_notes": "OUTPATIENT"
            }
          ],
          "minimum": 46.33,
          "maximum": 55.6
        }
      ]
    },
    {
      "description": "METHYLERGONOVINE 0.2 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-10572",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 44.35,
          "discounted_cash": 28.83,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 38.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 38.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 28.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33.26
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 24.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 28.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.39
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 35.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 12.11
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 39.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.37
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 28.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 44.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.38
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 28.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 24.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 24.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.03
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 24.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.87
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.7
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 29.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 35.88
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 28.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.37
            }
          ]
        }
      ]
    },
    {
      "description": "METOLAZONE 2.5 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-10587",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.4,
          "discounted_cash": 6.76,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            }
          ]
        }
      ]
    },
    {
      "description": "DONEPEZIL 23 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-105906",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.9,
          "discounted_cash": 3.83,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "AETNA [310]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "ANTHEM [335]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
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              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.19
            }
          ]
        }
      ]
    },
    {
      "description": "MICONAZOLE NITRATE 2 % TOPICAL POWDER",
      "drug_information": {
        "unit": "71",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-10599",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.65,
          "discounted_cash": 1.72,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.17
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.93
            }
          ]
        }
      ]
    },
    {
      "description": "BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL FILM",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-106176",
          "type": "CDM"
        },
        {
          "code": "J0572",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 14.4,
          "discounted_cash": 9.36,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 12.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.99
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 9.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.37
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.94
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.51
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 9.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.81
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 12.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.37
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 14.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 14.4,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 12.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.81
            }
          ]
        }
      ]
    },
    {
      "description": "FOSAPREPITANT 150 MG INTRAVENOUS POWDER FOR SOLUTION",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-106783",
          "type": "CDM"
        },
        {
          "code": "J1453",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 241.9,
          "discounted_cash": 157.23,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 212.15
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 157.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 133.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 133.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 176.59
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 152.88
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45.63,
              "estimated_amount": 45.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 200.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.3
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 212.87
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 176.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 198.36
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 198.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 157.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 152.88
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 152.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57,
              "estimated_amount": 57
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 176.59
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 133.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 133.05
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 159.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45.63,
              "estimated_amount": 45.63
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57,
              "estimated_amount": 57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 184.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 184.81
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 157.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 195.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.62
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57,
              "estimated_amount": 57
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 152.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 152.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57,
              "estimated_amount": 57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 176.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 198.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 198.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 198.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 157.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57,
              "estimated_amount": 57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 152.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57,
              "estimated_amount": 57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57,
              "estimated_amount": 57
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.62
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 351,
              "estimated_amount": 351
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45.63,
              "estimated_amount": 45.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 198.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57,
              "estimated_amount": 57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57,
              "estimated_amount": 57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57,
              "estimated_amount": 57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 181.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45.63,
              "estimated_amount": 45.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 45.63,
              "estimated_amount": 45.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 133.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57,
              "estimated_amount": 57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 184.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 184.81
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 157.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57,
              "estimated_amount": 57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57,
              "estimated_amount": 57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 212.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 200.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 200.54
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 195.7
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 133.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 152.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 133.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57,
              "estimated_amount": 57
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 181.43
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 198.36
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 66.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57,
              "estimated_amount": 57
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 184.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 152.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 184.81
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 176.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 205.62
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 198.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 176.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 157.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57,
              "estimated_amount": 57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 181.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 155.3
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 57,
              "estimated_amount": 57
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 241.9,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 45.63,
          "maximum": 351
        }
      ]
    },
    {
      "description": "NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "4",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-10734",
          "type": "CDM"
        },
        {
          "code": "J3490",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 53.55,
          "discounted_cash": 34.81,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.38
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 34.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 43.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 43.32
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 14.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 35.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.09
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.09
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.39
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.91
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.09
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.91
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 47.12
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.84
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.39
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.38
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.91
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.52
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34.86
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 46.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.91
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.52
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 46.96
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.52
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.55,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.45
            }
          ]
        }
      ]
    },
    {
      "description": "BUPRENORPHINE 5 MCG/HOUR WEEKLY TRANSDERMAL PATCH",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-107660",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 114.05,
          "discounted_cash": 74.13,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 72.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 63.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 85.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 72.08
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 100.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 72.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 92.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 87.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 72.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 94.55
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 100.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 114.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 87.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 93.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 72.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 62.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 87.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 62.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 83.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 93.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 74.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 100.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 87.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 72.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 74.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 83.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 94.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 87.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 74.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 63.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 93.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 93.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 63.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 93.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 72.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 62.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 83.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 87.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 85.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 92.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 62.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 74.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.22
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 75.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 74.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 72.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 62.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 83.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.94
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 83.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 83.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 74.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.62
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 85.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 74.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 93.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 74.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 93.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 93.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 74.02
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 63.3
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 31.14
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 74.13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 62.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 62.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 114.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 94.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.94
            }
          ]
        }
      ]
    },
    {
      "description": "LURASIDONE 40 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-107668",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 12.35,
          "discounted_cash": 8.03,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.02
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 8.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.76
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.83
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.76
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 12.35
            }
          ]
        }
      ]
    },
    {
      "description": "BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION",
      "drug_information": {
        "unit": "15",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-10781",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 31.65,
          "discounted_cash": 20.57,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 31.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.95
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 20.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.95
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.1
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 27.76
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 20.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 26.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 25.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.18
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 26.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 26.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 31.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 27.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 25.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.9
            }
          ]
        }
      ]
    },
    {
      "description": "PREDNISOLONE 15 MG/5 ML ORAL SOLUTION",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-11117",
          "type": "CDM"
        },
        {
          "code": "J7510",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.2,
          "discounted_cash": 3.38,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.97
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.86
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.31
            }
          ]
        }
      ]
    },
    {
      "description": "PYRIDOSTIGMINE BROMIDE 60 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-11239",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.7,
          "discounted_cash": 3.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.56
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            }
          ]
        }
      ]
    },
    {
      "description": "SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-11395",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.2,
          "discounted_cash": 0.78,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.33
            }
          ]
        }
      ]
    },
    {
      "description": "TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION",
      "drug_information": {
        "unit": "0.25",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-11507",
          "type": "CDM"
        },
        {
          "code": "J3105",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 34.75,
          "discounted_cash": 22.59,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.54
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.31
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.31
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.25,
              "estimated_amount": 14.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.37
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.54
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 30.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.48
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.25,
              "estimated_amount": 14.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.48
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.25,
              "estimated_amount": 14.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.25,
              "estimated_amount": 14.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.37
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.31
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.25,
              "estimated_amount": 14.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.31
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.11
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.54
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.31
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 22.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.11
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.31
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.81
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            }
          ],
          "minimum": 6.15,
          "maximum": 14.25
        }
      ]
    },
    {
      "description": "TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT",
      "drug_information": {
        "unit": "3.5",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-11566",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 924.95,
          "discounted_cash": 601.22,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 593.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 508.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 766.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 602.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 602.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 580.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 580.87
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 693.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 766.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 593.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 593.82
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 786.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 602.14
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 786.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 584.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 675.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 758.46
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 601.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 580.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 600.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 600.29
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 924.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 508.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 580.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 580.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 593.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 706.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 811.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 675.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 675.21
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 813.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 786.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 584.57
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 610.47
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 786.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 513.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 758.46
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 786.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 513.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 580.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 593.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 706.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 508.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 584.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 584.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 924.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 593.82
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 786.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 748.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 602.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 580.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 786.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 675.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 706.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 508.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 508.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 593.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 693.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 706.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 584.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 758.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 580.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 580.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 811.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 600.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 758.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 584.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 786.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 758.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 786.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 706.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 593.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 706.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 580.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 593.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 693.71
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 786.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 580.87
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 252.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 786.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 600.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 675.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 513.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 758.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 602.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 786.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 580.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 508.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 593.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 584.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 758.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 675.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 580.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 593.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 593.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 508.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 513.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 758.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 584.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 748.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 766.78
            }
          ]
        }
      ]
    },
    {
      "description": "ANTIHEMOPHILIC FACTOR VIII, FULL LENGTH 4,000 (+/-) UNIT IV SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-117087",
          "type": "CDM"
        },
        {
          "code": "J7192",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 30204.8,
          "discounted_cash": 19633.12,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19391.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19391.48
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16763.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19391.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22049.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19663.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19663.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19391.48
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 5436.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16763.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8800,
              "estimated_amount": 8800
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22049.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16763.66
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19391.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19391.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8800,
              "estimated_amount": 8800
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19663.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22049.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5934.88,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8800,
              "estimated_amount": 8800
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19391.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19391.48
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19391.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 25039.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19391.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16763.66
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19663.32
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 25039.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8800,
              "estimated_amount": 8800
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 25039.78
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 5436.86
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 24435.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8800,
              "estimated_amount": 8800
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8800,
              "estimated_amount": 8800
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22049.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22049.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8800,
              "estimated_amount": 8800
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8800,
              "estimated_amount": 8800
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19663.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 30204.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19391.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8800,
              "estimated_amount": 8800
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 6614.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 24435.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22049.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5934.88,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19391.48
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8800,
              "estimated_amount": 8800
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6024,
              "estimated_amount": 6024
            }
          ],
          "minimum": 6024,
          "maximum": 8800
        }
      ]
    },
    {
      "description": "BUPRENORPHINE 4 MG-NALOXONE 1 MG SUBLINGUAL FILM",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-119050",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 24.15,
          "discounted_cash": 15.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 19.54
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 21.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 15.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.17
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 15.7
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 21.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 15.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 15.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 21.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.63
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.53
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.26
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.53
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 15.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 15.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 19.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.17
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 24.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.53
            }
          ]
        }
      ]
    },
    {
      "description": "CYANOCOBALAMIN 2 MG-LEVOMEFOLATE CAL 1.13 MG-PYRIDOXINE 25 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-119963",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.3,
          "discounted_cash": 6.69,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.54
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.54
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.87
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.76
            }
          ]
        }
      ]
    },
    {
      "description": "THROMBIN (BOVINE) 20,000 UNIT TOPICAL SPRAY",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-121891",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 699.95,
          "discounted_cash": 454.97,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 594.96
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 510.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 534.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 442.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.57
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 534.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 510.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 524.96
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 615.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 384.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 454.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.57
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 594.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 384.97
            },
            {
              "payer_name": "OSU [553]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 510.96
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 454.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 594.96
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
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              "standard_charge_percentage": 66,
              "estimated_amount": 461.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.57
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 191.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 699.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 573.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 573.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
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              "standard_charge_percentage": 82.9,
              "estimated_amount": 580.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 454.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 388.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 573.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 455.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 442.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 534.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 534.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 442.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.57
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 524.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 510.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 442.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 613.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 566.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 384.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 510.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 442.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 573.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 455.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 594.96
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 594.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 384.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 388.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 454.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 594.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 594.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 388.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 442.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 510.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 573.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 566.26
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 594.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 455.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 455.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 442.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 613.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 524.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.57
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 699.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 442.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 573.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 384.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 388.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 580.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 454.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 384.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 449.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 439.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 580.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 573.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 534.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 594.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 455.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 534.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 594.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 384.97
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 594.96
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 594.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 573.96
            }
          ]
        }
      ]
    },
    {
      "description": "BUPIVACAINE-EPINEPHRINE (PF) 0.75 %-1:200,000 INJECTION SOLUTION",
      "drug_information": {
        "unit": "30",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-125509",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 92.5,
          "discounted_cash": 60.12,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 58.09
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 92.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 58.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.39
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 74.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 58.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 51.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 51.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 76.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 74.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 58.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 51.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 69.38
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.63
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.63
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.63
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 81.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 60.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 58.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 76.68
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 69.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 58.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 76.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 92.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 60.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 58.09
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 69.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 60.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 58.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.39
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 60.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 60.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 51.34
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 25.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 60.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 58.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.67
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 61.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 58.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 60.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 58.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 81.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 60.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.85
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 60.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 58.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 58.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 60.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 81.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.67
            }
          ]
        }
      ]
    },
    {
      "description": "ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION",
      "drug_information": {
        "unit": "240",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-127343",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 103.15,
          "discounted_cash": 67.05,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 87.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 84.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 90.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 77.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 78.81
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 90.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 87.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 56.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 84.58
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 67.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.22
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 87.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.19
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 68.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 28.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 87.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 78.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 77.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 83.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 56.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 57.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 103.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 56.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 84.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 66.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 66.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 85.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 84.58
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 87.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.22
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 87.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 103.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 56.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 57.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 87.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 85.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 85.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 84.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 56.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 83.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 78.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 78.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 87.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 77.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 56.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 57.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 87.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 78.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 90.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 64.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 66.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 78.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 87.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.22
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 87.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 87.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 84.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 84.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 56.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 57.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 66.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 84.58
            }
          ]
        }
      ]
    },
    {
      "description": "MULTIVIT-MIN-FOLIC ACID 0.4 MG-LYCOPENE 300 MCG-LUTEIN 250 MCG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-127719",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.05,
          "discounted_cash": 0.03,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            }
          ]
        }
      ]
    },
    {
      "description": "HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE",
      "drug_information": {
        "unit": ".5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-128822",
          "type": "CDM"
        },
        {
          "code": "90744",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 165.1,
          "discounted_cash": 107.31,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 126.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 126.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 105.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 104.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72,
              "estimated_amount": 72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 135.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72,
              "estimated_amount": 72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 135.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72,
              "estimated_amount": 72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 135.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 105.99
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 83.39,
              "estimated_amount": 83.39
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 107.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 83.39,
              "estimated_amount": 83.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 105.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 136.87
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 165.1,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 126.14
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 108.97
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 123.83
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 104.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 120.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 120.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 120.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 144.79
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 165.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 135.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 90.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 144.79
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 120.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 135.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 105.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 83.39,
              "estimated_amount": 83.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 126.14
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.34
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 45.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 107.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 90.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 83.39,
              "estimated_amount": 83.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 83.39,
              "estimated_amount": 83.39
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 83.39,
              "estimated_amount": 83.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 135.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 107.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 107.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 105.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 104.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 104.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 83.39,
              "estimated_amount": 83.39
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 165.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 90.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 90.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 120.52
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 165.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 105.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 83.39,
              "estimated_amount": 83.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 104.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 126.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 83.39,
              "estimated_amount": 83.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72,
              "estimated_amount": 72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 133.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 83.39,
              "estimated_amount": 83.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 105.99
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 107.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 83.39,
              "estimated_amount": 83.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 123.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 104.34
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 145.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 105.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 105.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 105.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 123.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 83.39,
              "estimated_amount": 83.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 83.39,
              "estimated_amount": 83.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 90.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 90.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72,
              "estimated_amount": 72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 136.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 90.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 83.39,
              "estimated_amount": 83.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 83.39,
              "estimated_amount": 83.39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 126.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 104.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 107.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 83.39,
              "estimated_amount": 83.39
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 165.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 120.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 104.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 135.38
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 165.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 105.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 105.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 136.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 135.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 133.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 83.39,
              "estimated_amount": 83.39
            }
          ],
          "minimum": 72,
          "maximum": 83.39
        }
      ]
    },
    {
      "description": "WHITE PETROLATUM-MINERAL OIL 80 %-20 % EYE OINTMENT",
      "drug_information": {
        "unit": "3.5",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-129591",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 23.25,
          "discounted_cash": 15.11,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 23.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.07
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.93
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 15.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 15.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 20.39
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 20.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 15.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.93
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 15.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 15.09
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.44
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.93
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.07
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 20.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 15.09
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 6.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19.27
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 23.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.07
            }
          ]
        }
      ]
    },
    {
      "description": "CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-1300",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.05,
          "discounted_cash": 0.03,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            }
          ]
        }
      ]
    },
    {
      "description": "KETAMINE 50 MG/5 ML (10 MG/ML) IN 0.9 % SODIUM CHLORIDE IV SYRINGE",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-130165",
          "type": "CDM"
        },
        {
          "code": "J7999",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 62.15,
          "discounted_cash": 40.4,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.9
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 46.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.9
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 54.51
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 51.52
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.48
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 41.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.96
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 51.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 51.52
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 62.15
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 40.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.48
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 50.28
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 46.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 16.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 46.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 50.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.96
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 54.51
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.9
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.18
            }
          ]
        }
      ]
    },
    {
      "description": "CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-1306",
          "type": "CDM"
        },
        {
          "code": "J3490",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 51.5,
          "discounted_cash": 33.47,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.35
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 42.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.23
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.33
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 45.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 38.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 41.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.33
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 38.63
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.23
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.6
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 38.63
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 42.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 41.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 45.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 42.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 33.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 45.17
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 33.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.23
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "SRD"
            }
          ]
        }
      ]
    },
    {
      "description": "THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-131124",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.15,
          "discounted_cash": 0.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            }
          ]
        }
      ]
    },
    {
      "description": "TETRACAINE HCL (PF) 0.5 % EYE DROPS",
      "drug_information": {
        "unit": "4",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-131372",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 54,
          "discounted_cash": 35.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 35.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 43.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 35.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.42
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 47.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 47.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 47.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 35.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.42
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 14.74
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 35.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 43.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 35.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.13
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.7
            }
          ]
        }
      ]
    },
    {
      "description": "VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-132049",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.25,
          "discounted_cash": 5.36,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.67
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.84
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.01
            }
          ]
        }
      ]
    },
    {
      "description": "ACETAMINOPHEN 300 MG-CODEINE 30 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-14087",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.3,
          "discounted_cash": 6.04,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.63
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.91
            }
          ]
        }
      ]
    },
    {
      "description": "KETOCONAZOLE 2 % SHAMPOO",
      "drug_information": {
        "unit": "120",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-14132",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 64.45,
          "discounted_cash": 41.89,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 42.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.47
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.73
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.77
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 52.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 56.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 64.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 52.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.34
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 56.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.85
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.47
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 56.52
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.34
            }
          ]
        }
      ]
    },
    {
      "description": "FLUCONAZOLE 40 MG/ML ORAL SUSPENSION",
      "drug_information": {
        "unit": "1.3",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-14233",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.2,
          "discounted_cash": 4.68,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.12
            }
          ]
        }
      ]
    },
    {
      "description": "SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION",
      "drug_information": {
        "unit": "15",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-15706",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.7,
          "discounted_cash": 6.95,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.87
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.94
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.96
            }
          ]
        }
      ]
    },
    {
      "description": "LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-15956",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 37.95,
          "discounted_cash": 24.67,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 24.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 24.63
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 24.67
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 24.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.36
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 10.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 24.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.99
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.26
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.46
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 21.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 21.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.99
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.26
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 21.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.36
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 21.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.26
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.83
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 33.4
            }
          ]
        }
      ]
    },
    {
      "description": "GLIMEPIRIDE 1 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-16355",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.7,
          "discounted_cash": 4.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.35
            }
          ]
        }
      ]
    },
    {
      "description": "SODIUM GLYCEROPHOSPHATE 1 MMOL/ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "20",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-164645",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 86.15,
          "discounted_cash": 56,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 65.82
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 23.52
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 56.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 56.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 56.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 56.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 55.91
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 75.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 56.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 56.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 54.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 70.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 54.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 54.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 70.64
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 75.55
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 86.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 70.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 70.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 54.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 70.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 70.64
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 54.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 69.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 54.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 70.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.38
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 86.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 54.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 70.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 65.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 62.89
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 55.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 54.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 55.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 65.82
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 54.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 54.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 65.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 64.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 71.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 54.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 71.42
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 64.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 55.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 75.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 71.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 65.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 54.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 65.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 54.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.23
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 69.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 64.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.23
            }
          ]
        }
      ]
    },
    {
      "description": "CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-1649",
          "type": "CDM"
        },
        {
          "code": "J3230",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 86.75,
          "discounted_cash": 56.39,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 66.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 66.28
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 65.06
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.09,
              "estimated_amount": 75.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.09,
              "estimated_amount": 75.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.38,
              "estimated_amount": 65.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.74
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.74
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 56.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.38,
              "estimated_amount": 65.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.38,
              "estimated_amount": 65.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 56.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.09,
              "estimated_amount": 75.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.09,
              "estimated_amount": 75.09
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.38,
              "estimated_amount": 65.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 71.14
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.09,
              "estimated_amount": 75.09
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.74
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 57.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 71.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.09,
              "estimated_amount": 75.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.71
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 66.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 76.08
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.69
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 56.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 71.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 71.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 56.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.09,
              "estimated_amount": 75.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.74
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 70.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.09,
              "estimated_amount": 75.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.09,
              "estimated_amount": 75.09
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.09,
              "estimated_amount": 75.09
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.38,
              "estimated_amount": 65.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.74
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.74
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 76.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.09,
              "estimated_amount": 75.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.09,
              "estimated_amount": 75.09
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 65.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 71.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.09,
              "estimated_amount": 75.09
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 65.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 70.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.09,
              "estimated_amount": 75.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 71.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 47.71
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 76.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 66.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 71.92
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 71.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 66.28
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 63.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 71.92
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 56.47
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 66.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.09,
              "estimated_amount": 75.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.74
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 86.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.09,
              "estimated_amount": 75.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 75.09,
              "estimated_amount": 75.09
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 23.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 56.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.74
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 71.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 71.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 55.69
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 73.74
            }
          ],
          "minimum": 65.38,
          "maximum": 75.09
        }
      ]
    },
    {
      "description": "CHLORTHALIDONE 25 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-1661",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.5,
          "discounted_cash": 5.52,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.21
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.23
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.46
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.21
            }
          ]
        }
      ]
    },
    {
      "description": "MORPHINE 10 MG/ML INTRAVENOUS SYRINGE",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-171060",
          "type": "CDM"
        },
        {
          "code": "J2270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 56.4,
          "discounted_cash": 36.66,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 45.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.44,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 36.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.72
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.09
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 42.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.44,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 15.4
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.09
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 42.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.44,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.44,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 49.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.44,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 45.63
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 37.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 46.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.17
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 49.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 42.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 56.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 49.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.25
            }
          ],
          "minimum": 10.44,
          "maximum": 13.12
        }
      ]
    },
    {
      "description": "PEGFILGRASTIM 6 MG/0.6 ML (DELIVERABLE) WEARABLE SUBCUTANEOUS INJECTOR",
      "drug_information": {
        "unit": "0.6",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-172050",
          "type": "CDM"
        },
        {
          "code": "J2506",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 15393,
          "discounted_cash": 10005.45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11760.25
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 10159.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8466.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9728.38
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15393,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 2770.74
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15393,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11236.89
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 10005.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12622.26
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12622.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12622.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11544.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11760.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 13499.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12760.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12622.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9728.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11236.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11760.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11236.89
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8466.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12622.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3081.78,
              "estimated_amount": 3081.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11760.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8466.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12622.26
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 2770.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11236.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3081.78,
              "estimated_amount": 3081.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3081.78,
              "estimated_amount": 3081.78
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4202.29
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3081.78,
              "estimated_amount": 3081.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12760.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 13499.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11236.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12622.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8466.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3081.78,
              "estimated_amount": 3081.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11544.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9728.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10020.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11236.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12760.8
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 13545.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10020.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11760.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11760.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11544.75
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1355.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 3371.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10020.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8466.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9728.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12452.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10020.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8466.15
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15393,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12452.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10020.84
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9728.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9728.38
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8466.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9728.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9728.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12622.26
            }
          ],
          "minimum": 1792.8,
          "maximum": 3081.78
        }
      ]
    },
    {
      "description": "IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "100",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-172923",
          "type": "CDM"
        },
        {
          "code": "J1569",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3021.95,
          "discounted_cash": 1964.27,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1940.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1940.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1909.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2206.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2505.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1940.09
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1967.29
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2444.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2568.66
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2266.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2308.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1662.07
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2568.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1967.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2442.8,
              "estimated_amount": 2442.8
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2478
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2478
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3021.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1967.29
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3021.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2478
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2568.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1909.87
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2266.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2442.8,
              "estimated_amount": 2442.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3021.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2568.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2206.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2308.77
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 894.8,
              "estimated_amount": 894.8
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1994.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2022.7,
              "estimated_amount": 2022.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2442.8,
              "estimated_amount": 2442.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2206.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2650.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2442.8,
              "estimated_amount": 2442.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1940.09
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1964.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2308.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1909.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2442.8,
              "estimated_amount": 2442.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2022.7,
              "estimated_amount": 2022.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1940.09
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 889.53,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2442.8,
              "estimated_amount": 2442.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2505.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2478
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2478
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2442.8,
              "estimated_amount": 2442.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2568.66
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2266.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1909.87
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3021.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1662.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2022.7,
              "estimated_amount": 2022.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2022.7,
              "estimated_amount": 2022.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2206.02
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1967.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2442.8,
              "estimated_amount": 2442.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2568.66
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2659.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1909.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2442.8,
              "estimated_amount": 2442.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1662.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2478
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1662.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2442.8,
              "estimated_amount": 2442.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2442.8,
              "estimated_amount": 2442.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2442.8,
              "estimated_amount": 2442.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1940.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2650.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2568.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2568.66
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2568.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1940.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2308.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1940.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2568.66
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2568.66
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2442.8,
              "estimated_amount": 2442.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1909.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2022.7,
              "estimated_amount": 2022.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2442.8,
              "estimated_amount": 2442.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1940.09
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 824.99
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2568.66
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3021.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1909.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2206.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1940.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1662.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2478
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2308.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2442.8,
              "estimated_amount": 2442.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2478
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 661.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1662.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2206.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1940.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1940.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2442.8,
              "estimated_amount": 2442.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2442.8,
              "estimated_amount": 2442.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2308.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1967.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2568.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1662.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2505.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2444.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1909.87
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 847.17,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 894.8,
          "maximum": 2442.8
        }
      ]
    },
    {
      "description": "BUPRENORPHINE HCL 75 MCG BUCCAL FILM",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-175759",
          "type": "CDM"
        },
        {
          "code": "J0571",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 35.75,
          "discounted_cash": 23.24,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.66
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 23.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.32
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.1
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.31
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.59
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 23.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.59
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 31.46
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.92
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 35.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.1
            }
          ]
        }
      ]
    },
    {
      "description": "TRASTUZUMAB 150 MG INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "7.1415",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-181723",
          "type": "CDM"
        },
        {
          "code": "J9355",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5578.1,
          "discounted_cash": 3625.76,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3581.14
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1687.05,
              "estimated_amount": 1687.05
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4574.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4741.39
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1004.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2809.76,
              "estimated_amount": 2809.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4574.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4574.04
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3581.14
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3174,
              "estimated_amount": 3174
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4261.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3581.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2809.76,
              "estimated_amount": 2809.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4512.68
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3174,
              "estimated_amount": 3174
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4261.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3581.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3525.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4574.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4072.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3525.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3174,
              "estimated_amount": 3174
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3067.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3631.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3067.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4574.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1221.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4261.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3525.36
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4741.39
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4261.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3525.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3174,
              "estimated_amount": 3174
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4624.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4741.39
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4741.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3581.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3625.77
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4741.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3581.14
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4908.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3174,
              "estimated_amount": 3174
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3174,
              "estimated_amount": 3174
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4072.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3581.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3525.36
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1235.54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4624.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3174,
              "estimated_amount": 3174
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3631.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3174,
              "estimated_amount": 3174
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3067.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3174,
              "estimated_amount": 3174
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4741.39
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1522.82
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4741.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3174,
              "estimated_amount": 3174
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4741.39
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1004.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3067.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4072.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4741.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3067.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4072.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3174,
              "estimated_amount": 3174
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3631.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3174,
              "estimated_amount": 3174
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4741.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3525.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4072.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3581.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4891.99
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3581.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3525.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3174,
              "estimated_amount": 3174
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3174,
              "estimated_amount": 3174
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3174,
              "estimated_amount": 3174
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4072.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4624.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4512.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3581.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3174,
              "estimated_amount": 3174
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3067.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3581.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3581.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4574.04
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5578.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4261.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3631.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2809.76,
              "estimated_amount": 2809.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4574.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4261.67
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4183.58
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3681.55
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5578.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2809.76,
              "estimated_amount": 2809.76
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4574.04
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4741.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3525.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3631.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4891.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4741.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3067.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2809.76,
              "estimated_amount": 2809.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1176.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4741.39
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5578.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4183.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3174,
              "estimated_amount": 3174
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4183.58
            }
          ],
          "minimum": 1687.05,
          "maximum": 3174
        }
      ]
    },
    {
      "description": "CLINDAMYCIN 600 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK",
      "drug_information": {
        "unit": "50",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-181755",
          "type": "CDM"
        },
        {
          "code": "J0737",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 79.3,
          "discounted_cash": 51.54,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 59.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.66,
              "estimated_amount": 17.66
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.66,
              "estimated_amount": 17.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.66,
              "estimated_amount": 17.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 60.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.12
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 69.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.66,
              "estimated_amount": 17.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.66,
              "estimated_amount": 17.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 60.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.66,
              "estimated_amount": 17.66
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 79.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.34,
              "estimated_amount": 10.34
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 79.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 60.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 60.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.89
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.66,
              "estimated_amount": 17.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.34,
              "estimated_amount": 10.34
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 79.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.66,
              "estimated_amount": 17.66
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 59.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.41
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.41
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 21.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.34,
              "estimated_amount": 10.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 65.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 60.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 65.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.66,
              "estimated_amount": 17.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.66,
              "estimated_amount": 17.66
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 51.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 59.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 52.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 69.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.66,
              "estimated_amount": 17.66
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 79.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.34,
              "estimated_amount": 10.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 79.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 64.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.66,
              "estimated_amount": 17.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 69.55
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 79.3,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 64.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.66,
              "estimated_amount": 17.66
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 60.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 50.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.66,
              "estimated_amount": 17.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.34,
              "estimated_amount": 10.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.91
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 57.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.66,
              "estimated_amount": 17.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 50.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 65.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 67.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.66,
              "estimated_amount": 17.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.66,
              "estimated_amount": 17.66
            }
          ],
          "minimum": 10.34,
          "maximum": 17.66
        }
      ]
    },
    {
      "description": "PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "22.22",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-18302",
          "type": "CDM"
        },
        {
          "code": "J2543",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 64.8,
          "discounted_cash": 42.12,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.51
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.92,
              "estimated_amount": 11.92
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.51
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.14
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.6
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.92,
              "estimated_amount": 11.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.14
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.51
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.92,
              "estimated_amount": 11.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.92,
              "estimated_amount": 11.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 52.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.08
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.6
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.92,
              "estimated_amount": 11.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.92,
              "estimated_amount": 11.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.92,
              "estimated_amount": 11.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.83,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.08
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.92,
              "estimated_amount": 11.92
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.92,
              "estimated_amount": 11.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.6
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 42.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.51
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.08
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 56.83
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.14
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 57.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.6
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.92,
              "estimated_amount": 11.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.92,
              "estimated_amount": 11.92
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.08
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.6
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.95
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.92,
              "estimated_amount": 11.92
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 56.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.92,
              "estimated_amount": 11.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.83,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.92,
              "estimated_amount": 11.92
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.83,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 52.42
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 42.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.92,
              "estimated_amount": 11.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.92,
              "estimated_amount": 11.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.08
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.83,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.14
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.92,
              "estimated_amount": 11.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.83,
              "estimated_amount": 9.83
            }
          ],
          "minimum": 9.83,
          "maximum": 11.92
        }
      ]
    },
    {
      "description": "PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "11.5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-18304",
          "type": "CDM"
        },
        {
          "code": "J2543",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 44,
          "discounted_cash": 28.6,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 35.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.64
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.62
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.94,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.81
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 38.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.94,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 35.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.08
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 29.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.81
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.08
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.94,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.2
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 38.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.25
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.94,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.94,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 38.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.12
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.94,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.12
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.94,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.94,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.94,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.94,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.94,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.81
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.94,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.94,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 12.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.94,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.94,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.12
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.94,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.94,
              "estimated_amount": 8.94
            }
          ],
          "minimum": 7.37,
          "maximum": 8.94
        }
      ]
    },
    {
      "description": "RISPERIDONE 1 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-18313",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5,
          "discounted_cash": 3.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            }
          ]
        }
      ]
    },
    {
      "description": "SARILUMAB 200 MG/1.14 ML SUBCUTANEOUS PEN INJECTOR",
      "drug_information": {
        "unit": "1.14",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-184963",
          "type": "CDM"
        },
        {
          "code": "J3590",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10621.9,
          "discounted_cash": 6904.23,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6819.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7753.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5842.05
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8805.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6819.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9028.62
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7966.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6819.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6819.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8115.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7753.99
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8115.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9028.62
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9028.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8709.96
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6713.04
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9028.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6819.26
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9028.62
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6904.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9028.62
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9028.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5842.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8709.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6713.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6914.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9028.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6819.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6819.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9315.41
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9028.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8115.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 2326.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9315.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1911.94
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8115.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6713.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6914.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8593.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9028.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7753.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8709.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8709.96
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6914.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8115.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6713.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8709.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8709.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6713.04
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7010.45
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8805.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5842.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8593.12
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1911.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6819.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6819.26
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7966.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6713.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7753.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8115.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6713.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6914.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7753.99
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9028.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9028.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6819.26
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9347.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9028.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5842.05
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7753.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8709.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8709.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6819.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6713.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5842.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5842.05
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2899.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6819.26
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7966.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6914.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5842.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8805.56
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9028.62
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10621.9,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "VANCOMYCIN 1.5 GRAM INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "15",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-186889",
          "type": "CDM"
        },
        {
          "code": "J3370",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 91.45,
          "discounted_cash": 59.44,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.73
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.11,
              "estimated_amount": 18.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 68.59
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.73
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 75.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 24.97
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.73
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.87
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 60.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 68.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.3
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.73
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.87
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.11,
              "estimated_amount": 18.11
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 80.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.11,
              "estimated_amount": 18.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.99
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 73.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.99
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.3
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 59.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 68.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 75.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 73.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.55,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.11,
              "estimated_amount": 18.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 80.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.11,
              "estimated_amount": 18.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 80.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.73
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 75.81
            }
          ],
          "minimum": 17.55,
          "maximum": 18.11
        }
      ]
    },
    {
      "description": "TRASTUZUMAB-ANNS 150 MG INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "7.1429",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-189403",
          "type": "CDM"
        },
        {
          "code": "Q5117",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5227.9,
          "discounted_cash": 3398.13,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3356.31
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 620.57,
              "estimated_amount": 620.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3403.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2875.35
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1427.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4333.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3304.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4333.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4286.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3403.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 786.15,
              "estimated_amount": 786.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4443.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3403.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 620.57,
              "estimated_amount": 620.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4443.72
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1144.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3356.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3356.31
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4443.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2875.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 786.15,
              "estimated_amount": 786.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4443.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3356.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4286.88
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4443.72
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3356.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3994.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3816.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4286.88
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3994.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4443.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4443.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4229.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 620.57,
              "estimated_amount": 620.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3994.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4584.87
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3450.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 786.15,
              "estimated_amount": 786.15
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4443.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2875.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 620.57,
              "estimated_amount": 620.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 786.15,
              "estimated_amount": 786.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 786.15,
              "estimated_amount": 786.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3994.12
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4443.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 786.15,
              "estimated_amount": 786.15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3304.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3920.93
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3920.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3403.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4229.37
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4286.88
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5227.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3816.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4286.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 786.15,
              "estimated_amount": 786.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 786.15,
              "estimated_amount": 786.15
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4443.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3304.03
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4286.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3403.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3356.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4584.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 786.15,
              "estimated_amount": 786.15
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2875.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3816.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3356.31
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 786.15,
              "estimated_amount": 786.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 941.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4286.88
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3356.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3304.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3304.03
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3398.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 786.15,
              "estimated_amount": 786.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 786.15,
              "estimated_amount": 786.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3816.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3816.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 620.57,
              "estimated_amount": 620.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2875.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 786.15,
              "estimated_amount": 786.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3304.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2875.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2875.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3994.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 786.15,
              "estimated_amount": 786.15
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4443.72
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5227.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3304.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3304.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3356.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4443.72
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 272.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 786.15,
              "estimated_amount": 786.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 786.15,
              "estimated_amount": 786.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3994.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3356.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3356.31
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4443.72
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4600.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3356.31
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 259.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4333.93
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 941.02
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5227.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3816.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 786.15,
              "estimated_amount": 786.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4286.88
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3920.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4443.72
            }
          ],
          "minimum": 620.57,
          "maximum": 786.15
        }
      ]
    },
    {
      "description": "EPHEDRINE SULFATE 5 MG/ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-190916",
          "type": "CDM"
        },
        {
          "code": "J3490",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 37.75,
          "discounted_cash": 24.54,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.86
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 24.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.29
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.31
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.24
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.56
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 33.11
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.58
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.24
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 24.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.96
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.58
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.86
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.96
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.96
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.31
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 33.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.24
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 10.31
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 33.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.56
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.24
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.86
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.96
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.56
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.96
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.24
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.75,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "METHACHOLINE CHLORIDE 3 MG/3 ML (1 MG/ML) NEBULIZATION SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-192019",
          "type": "CDM"
        },
        {
          "code": "J7674",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 75.25,
          "discounted_cash": 48.91,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 60.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.71
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 48.91
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 49.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.99
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 66.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.39
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 65.99
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.39
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 65.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.44
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 60.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.71
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "SRD"
            }
          ]
        }
      ]
    },
    {
      "description": "KETAMINE 50 MG/5 ML (10 MG/ML) IN SODIUM CHLOR,ISO-OSMOTIC IV SYRINGE",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-198515",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 63.2,
          "discounted_cash": 41.08,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.13
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 55.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.14
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.69
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.69
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.82
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 41.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.39
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.69
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 41.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.43
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 63.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.69
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.4
            }
          ]
        }
      ]
    },
    {
      "description": "CYANOCOBALAMIN (VIT B-12) 500 MCG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-2012",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.2,
          "discounted_cash": 0.13,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            }
          ]
        }
      ]
    },
    {
      "description": "PRAMIPEXOLE 0.125 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-21287",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.8,
          "discounted_cash": 3.12,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.66
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            }
          ]
        }
      ]
    },
    {
      "description": "PRAMIPEXOLE 0.25 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-21290",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.1,
          "discounted_cash": 3.31,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            }
          ]
        }
      ]
    },
    {
      "description": "ROPINIROLE 0.5 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-21800",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.5,
          "discounted_cash": 3.57,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "MMO [485]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.57
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.56
            }
          ]
        }
      ]
    },
    {
      "description": "TIAGABINE 4 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-21827",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 23,
          "discounted_cash": 14.95,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.77
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 18.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.65
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 20.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 20.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.77
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 14.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 14.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 14.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.86
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 23,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 18.61
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 15.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 20.17
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.44
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 14.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 12.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 14.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.86
            }
          ]
        }
      ]
    },
    {
      "description": "REPAGLINIDE 0.5 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-22584",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.95,
          "discounted_cash": 3.22,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "CIGNA [370]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
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              "standard_charge_percentage": 66,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            }
          ]
        }
      ]
    },
    {
      "description": "CAPECITABINE 150 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-22993",
          "type": "CDM"
        },
        {
          "code": "J8522",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.15,
          "discounted_cash": 5.3,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.15
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.95
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.95
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.93
            }
          ]
        }
      ]
    },
    {
      "description": "TIROFIBAN 5 MG/100 ML (50 MCG/ML)-0.9 % SODIUM CHLORIDE INTRAVENOUS",
      "drug_information": {
        "unit": "100",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-23050",
          "type": "CDM"
        },
        {
          "code": "J3246",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 333.05,
          "discounted_cash": 216.48,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 214.6,
              "estimated_amount": 214.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 243.13
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 276.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 183.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.1
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 216.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 269.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 243.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 243.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 214.6,
              "estimated_amount": 214.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 214.6,
              "estimated_amount": 214.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 191.88,
              "estimated_amount": 191.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 292.08
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 249.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 214.6,
              "estimated_amount": 214.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.09
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 333.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 243.13
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 191.88,
              "estimated_amount": 191.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 276.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 216.82
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 333.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 191.88,
              "estimated_amount": 191.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 293.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 216.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 214.6,
              "estimated_amount": 214.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 243.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 214.6,
              "estimated_amount": 214.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 333.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 214.6,
              "estimated_amount": 214.6
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 183.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 216.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 214.6,
              "estimated_amount": 214.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 183.18
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 214.6,
              "estimated_amount": 214.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 214.6,
              "estimated_amount": 214.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 191.88,
              "estimated_amount": 191.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 269.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 183.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.09
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.09
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 219.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.49
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.1
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 214.6,
              "estimated_amount": 214.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 214.6,
              "estimated_amount": 214.6
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 90.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 292.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 214.6,
              "estimated_amount": 214.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 276.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 191.88,
              "estimated_amount": 191.88
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.09
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 214.6,
              "estimated_amount": 214.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 214.6,
              "estimated_amount": 214.6
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 333.05,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 183.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 249.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 214.6,
              "estimated_amount": 214.6
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 333.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.49
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.09
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84.44,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 183.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 243.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 183.18
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 333.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 216.82
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 216.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 214.6,
              "estimated_amount": 214.6
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 249.79
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.42,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 191.88,
          "maximum": 214.6
        }
      ]
    },
    {
      "description": "LIDOCAINE 4 % TOPICAL CREAM",
      "drug_information": {
        "unit": "5",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-23461",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.6,
          "discounted_cash": 1.69,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.69
            }
          ]
        }
      ]
    },
    {
      "description": "DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-2361",
          "type": "CDM"
        },
        {
          "code": "J7999",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 111.95,
          "discounted_cash": 72.77,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 30.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 90.57
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 73.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.72
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 83.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.87
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.16
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 62.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.53
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 98.52
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.16
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 72.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 62.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 92.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 92.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 62.13
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.72
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.87
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 111.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 92.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 90.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.53
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 98.18
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.88
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 83.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 98.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 83.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.87
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 62.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 111.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.75
            }
          ]
        }
      ]
    },
    {
      "description": "DICYCLOMINE 10 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-2418",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.6,
          "discounted_cash": 3.64,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            }
          ]
        }
      ]
    },
    {
      "description": "DOFETILIDE 125 MCG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-26965",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 17.2,
          "discounted_cash": 11.18,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.62
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 11.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.04
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 11.35
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 17.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.1
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 15.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 17.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.56
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.1
            }
          ]
        }
      ]
    },
    {
      "description": "PERITONEAL DIALYSIS SOLN 7-2.5 % DEXT.LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L",
      "drug_information": {
        "unit": "2000",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-27800",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 109.05,
          "discounted_cash": 70.88,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 90.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.98
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.42
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 60.52
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 81.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 70.99
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 88.22
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 29.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 60.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 90.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 95.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.31
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 71.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 81.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 95.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 60.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 70.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 81.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 70.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 79.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 79.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 70.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 79.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 70.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 70.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 109.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 90.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 95.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 88.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 79.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 79.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 70.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.42
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 70.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 79.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 70.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 70.99
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 109.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "ANTHEM [335]",
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              "standard_charge_percentage": 55.5,
              "estimated_amount": 60.52
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 99,
          "discounted_cash": 64.35,
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            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 62.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "estimated_amount": 81.18
            },
            {
              "payer_name": "CIGNA [370]",
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            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 62.17
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 64.25
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 75.64
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 62.57
            },
            {
              "payer_name": "MMO [485]",
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              "estimated_amount": 62.57
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 72.27
            },
            {
              "payer_name": "GREATWEST [550]",
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              "payer_name": "HEALTHREACH [540]",
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            },
            {
              "payer_name": "AETNA [310]",
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              "estimated_amount": 63.56
            },
            {
              "payer_name": "AETNA [310]",
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              "payer_name": "AETNA [310]",
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              "estimated_amount": 63.56
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              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
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            },
            {
              "payer_name": "COFINITY [407]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 62.17
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
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              "standard_charge_percentage": 75,
              "estimated_amount": 74.25
            },
            {
              "payer_name": "AETNA [310]",
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              "estimated_amount": 63.56
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            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 64.25
            },
            {
              "payer_name": "UHC [625]",
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              "payer_name": "CIGNA [370]",
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              "estimated_amount": 64.45
            },
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              "payer_name": "UHC [625]",
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              "estimated_amount": 62.17
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            },
            {
              "payer_name": "IHG [492]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
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              "payer_name": "AETNA [310]",
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              "payer_name": "AETNA [310]",
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              "payer_name": "MMO [485]",
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              "estimated_amount": 86.82
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
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              "estimated_amount": 27.03
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              "payer_name": "OSU [553]",
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            {
              "payer_name": "OSU [553]",
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              "payer_name": "HEALTHREACH [540]",
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              "estimated_amount": 54.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
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              "estimated_amount": 74.25
            },
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              "payer_name": "UHC [625]",
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              "estimated_amount": 62.17
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              "payer_name": "UHC [625]",
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              "estimated_amount": 64.25
            },
            {
              "payer_name": "EMERALD [395]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 75.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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            },
            {
              "payer_name": "UHC [625]",
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              "estimated_amount": 62.17
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              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "estimated_amount": 81.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 81.18
            },
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              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
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              "estimated_amount": 54.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 81.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "HUMANA [465]",
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              "standard_charge_percentage": 65,
              "estimated_amount": 64.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 62.57
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 64.45
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 80.9,
              "estimated_amount": 80.09
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              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 62.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 62.17
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 62.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 64.45
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 64.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
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              "standard_charge_percentage": 55.5,
              "estimated_amount": 54.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 62.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 62.17
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 63.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 74.25
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 87.12
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 62.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 75.64
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 63.56
            },
            {
              "payer_name": "AHPO [305]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 64.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 75.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
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              "standard_charge_percentage": 100,
              "estimated_amount": 99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 82.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 62.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 81.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 62.57
            },
            {
              "payer_name": "OSU [553]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 72.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 81.18
            },
            {
              "payer_name": "AETNA [310]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 63.56
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
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              "standard_charge_percentage": 66,
              "estimated_amount": 65.34
            },
            {
              "payer_name": "ANTHEM [335]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 54.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 62.57
            },
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              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 80.09
            },
            {
              "payer_name": "AETNA [310]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 63.56
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 63.56
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "OSU [553]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 72.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 54.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 54.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 54.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 72.27
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 62.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 86.82
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 99,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 84.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 82.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 81.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 63.56
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 159.35,
          "discounted_cash": 103.58,
          "payers_information": [
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 132.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 159.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 103.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.07
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 88.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 103.42
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 159.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 116.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 88.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 121.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 119.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 103.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 121.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 116.33
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 119.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 132.1
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 105.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 88.44
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 128.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 116.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 103.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 119.51
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.07
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 116.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.67
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 43.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 88.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 121.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.3
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 103.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 139.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 121.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 116.33
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 128.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 132.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 121.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 116.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.71
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 103.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.45
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 140.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 121.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 103.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 103.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 103.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 139.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 103.74
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.45
            }
          ]
        }
      ]
    },
    {
      "description": "VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-27858",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.9,
          "discounted_cash": 3.83,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            }
          ]
        }
      ]
    },
    {
      "description": "LIDOCAINE 5 % TOPICAL PATCH",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-28203",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.9,
          "discounted_cash": 5.78,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.79
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
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              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.71
            }
          ]
        }
      ]
    },
    {
      "description": "LINEZOLID 600 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-28224",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.4,
          "discounted_cash": 6.76,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "GREATWEST [550]",
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              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.84
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.62
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            }
          ]
        }
      ]
    },
    {
      "description": "CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-28264",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.4,
          "discounted_cash": 3.51,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.48
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            }
          ]
        }
      ]
    },
    {
      "description": "CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM",
      "drug_information": {
        "unit": "15",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-29424",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 44.05,
          "discounted_cash": 28.63,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 24.23
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 32.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
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              "standard_charge_percentage": 55.5,
              "estimated_amount": 24.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.28
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.84
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
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              "standard_charge_percentage": 75,
              "estimated_amount": 33.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.66
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 24.23
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 28.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.12
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 24.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 28.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.23
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 38.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 44.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 24.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 38.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.28
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 24.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 28.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 28.59
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 12.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.84
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.28
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 38.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.16
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 28.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.28
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.66
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.84
            }
          ]
        }
      ]
    },
    {
      "description": "FERROUS SULFATE 325 MG (65 MG IRON) TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-3074",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.05,
          "discounted_cash": 0.03,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            }
          ]
        }
      ]
    },
    {
      "description": "VALSARTAN 80 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-31209",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.25,
          "discounted_cash": 4.71,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.16
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.95
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.95
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.01
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.87
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.95
            }
          ]
        }
      ]
    },
    {
      "description": "PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML INTRAVENOUS SUSPENSION",
      "drug_information": {
        "unit": "2.0007",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-31270",
          "type": "CDM"
        },
        {
          "code": "Q9957",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 569.85,
          "discounted_cash": 370.4,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 360.15
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 221.78,
              "estimated_amount": 221.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 221.78,
              "estimated_amount": 221.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 370.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 472.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 467.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 467.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 360.15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 360.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.37
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 360.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 313.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 313.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 415.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 435.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 360.15
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 370.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 370.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 208.17,
              "estimated_amount": 208.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 467.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 208.17,
              "estimated_amount": 208.17
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 360.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 221.78,
              "estimated_amount": 221.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 313.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 360.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 313.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 313.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 221.78,
              "estimated_amount": 221.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 370.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 221.78,
              "estimated_amount": 221.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.84
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 370.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 370.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 221.78,
              "estimated_amount": 221.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 360.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 461.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 221.78,
              "estimated_amount": 221.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 313.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 415.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 467.28
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 221.78,
              "estimated_amount": 221.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 208.17,
              "estimated_amount": 208.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 221.78,
              "estimated_amount": 221.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 221.78,
              "estimated_amount": 221.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 499.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 499.76
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 467.28
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.84
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 435.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.84
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 221.78,
              "estimated_amount": 221.78
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 435.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 221.78,
              "estimated_amount": 221.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 221.78,
              "estimated_amount": 221.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 427.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 415.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 472.41
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 415.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.37
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 435.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.84
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 461.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 221.78,
              "estimated_amount": 221.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 415.99
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 467.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 467.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 427.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 221.78,
              "estimated_amount": 221.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 221.78,
              "estimated_amount": 221.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 427.39
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.37
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.37
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.37
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 208.17,
              "estimated_amount": 208.17
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 313.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 415.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 435.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 472.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 221.78,
              "estimated_amount": 221.78
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 208.17,
              "estimated_amount": 208.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 467.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 435.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.84
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.37
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 155.57
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 501.47
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 569.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 376.1
            }
          ],
          "minimum": 208.17,
          "maximum": 221.78
        }
      ]
    },
    {
      "description": "BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-31576",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 18.05,
          "discounted_cash": 11.73,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13.54
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.59
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 11.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 11.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 18.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.59
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 11.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 11.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 11.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 18.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 11.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.75
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 15.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.41
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.18
            }
          ]
        }
      ]
    },
    {
      "description": "PARICALCITOL 2 MCG/ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-31688",
          "type": "CDM"
        },
        {
          "code": "J2501",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 51.5,
          "discounted_cash": 33.47,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.33
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 38.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.51,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 33.99
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 33.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.51,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 42.69
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.12,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.12,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.12,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.12,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.12,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 38.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.12,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.12,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 42.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.23
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.23
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 45.32
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.12,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.12,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 42.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.12,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.12,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.51,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.12,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 41.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.12,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.51,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 45.17
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.12,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.23
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.23
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.12,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.12,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.51,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.23
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.12,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 38.63
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 45.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 41.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.23
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 51.5,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 3.51,
          "maximum": 4.12
        }
      ]
    },
    {
      "description": "OXYCODONE-ACETAMINOPHEN 10 MG-325 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-31864",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 12.25,
          "discounted_cash": 7.96,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.97
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 8.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 12.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 10.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.36
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 7.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.19
            }
          ]
        }
      ]
    },
    {
      "description": "PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE",
      "drug_information": {
        "unit": "0.6",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-32267",
          "type": "CDM"
        },
        {
          "code": "J2506",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 15393,
          "discounted_cash": 10005.45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11760.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8466.15
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8466.15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15393,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12760.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9728.38
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8466.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12760.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12622.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12622.26
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 2770.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9728.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9728.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3081.78,
              "estimated_amount": 3081.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10020.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11760.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10020.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12622.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9728.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12622.26
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 3371.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10020.84
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11760.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11544.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3081.78,
              "estimated_amount": 3081.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8466.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3081.78,
              "estimated_amount": 3081.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10020.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9728.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12452.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12760.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 2770.74
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11236.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11236.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12622.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12622.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11236.89
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3081.78,
              "estimated_amount": 3081.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12622.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10020.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8466.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12452.94
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11760.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 13499.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9728.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8466.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4202.29
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15393,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9728.38
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8466.15
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 13545.84
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15393,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11544.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11236.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11236.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9728.38
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 10159.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9882.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11760.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 13499.66
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1355.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11544.75
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11236.89
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11760.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3081.78,
              "estimated_amount": 3081.78
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 10005.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12622.26
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13084.05
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1792.8,
              "estimated_amount": 1792.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1290.71,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 1792.8,
          "maximum": 3081.78
        }
      ]
    },
    {
      "description": "MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK",
      "drug_information": {
        "unit": "100",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-32950",
          "type": "CDM"
        },
        {
          "code": "J2260",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 77.2,
          "discounted_cash": 50.18,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.56
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.62
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 21.08
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.3
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.28,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.3
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 50.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.46
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.62
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.51,
              "estimated_amount": 14.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.51,
              "estimated_amount": 14.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.51,
              "estimated_amount": 14.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 62.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.28,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 57.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.79
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.79
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.28,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.28,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.28,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.28,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.98
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 57.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 67.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 57.9
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.56
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 50.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.28,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.28,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.28,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 64
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.79
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 67.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 50.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 50.26
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 50.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.28,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 50.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.28,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.28,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.51,
              "estimated_amount": 14.51
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.28,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 64
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.62
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.46
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 50.18
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.28,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.28,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.28,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.62
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 67.7
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.28,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.79
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 62.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 14.51,
              "estimated_amount": 14.51
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 77.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 65.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 63.3
            }
          ],
          "minimum": 14.51,
          "maximum": 15.28
        }
      ]
    },
    {
      "description": "AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-33228",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.55,
          "discounted_cash": 3.61,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.6
            }
          ]
        }
      ]
    },
    {
      "description": "CLOTRIMAZOLE 2 % VAGINAL CREAM",
      "drug_information": {
        "unit": "21",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-33986",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 30.8,
          "discounted_cash": 20.02,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 27.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 25.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.18
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 30.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.05
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.47
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 27.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 19.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.05
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 25.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 19.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.18
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 20.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 24.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 30.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 19.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 19.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 27.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 25.53
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.18
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 20.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 24.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.18
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.1
            }
          ]
        }
      ]
    },
    {
      "description": "GENTAMICIN 0.1 % TOPICAL CREAM",
      "drug_information": {
        "unit": "30",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-3423",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 66.7,
          "discounted_cash": 43.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.82
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 58.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 43.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 53.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 66.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.69
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 18.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 43.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.82
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 58.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.42
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 66.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 43.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.82
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 44.02
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 53.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.82
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 43.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 58.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.69
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.69
            }
          ]
        }
      ]
    },
    {
      "description": "BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-34713",
          "type": "CDM"
        },
        {
          "code": "J0572",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 12.5,
          "discounted_cash": 8.12,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.63
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 11
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.9
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 12.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.63
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.55
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 8.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.13
            }
          ]
        }
      ]
    },
    {
      "description": "ROSUVASTATIN 10 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-35134",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.85,
          "discounted_cash": 3.15,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.67
            }
          ]
        }
      ]
    },
    {
      "description": "HALOPERIDOL 1 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-3579",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.8,
          "discounted_cash": 3.77,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.69
            }
          ]
        }
      ]
    },
    {
      "description": "POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN",
      "drug_information": {
        "unit": "1000",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-36046",
          "type": "CDM"
        },
        {
          "code": "J3480",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 71.35,
          "discounted_cash": 46.38,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3,
              "estimated_amount": 3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 57.72
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.51
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.51
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 47.09
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.24
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.57,
              "estimated_amount": 2.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.51
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.6,
              "estimated_amount": 1.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 46.45
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.57,
              "estimated_amount": 2.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3,
              "estimated_amount": 3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 46.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 46.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 46.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3,
              "estimated_amount": 3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 46.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3,
              "estimated_amount": 3
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.24
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3,
              "estimated_amount": 3
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 19.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 57.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3,
              "estimated_amount": 3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 59.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.57,
              "estimated_amount": 2.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3,
              "estimated_amount": 3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 62.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3,
              "estimated_amount": 3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.57,
              "estimated_amount": 2.57
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3,
              "estimated_amount": 3
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 59.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3,
              "estimated_amount": 3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3,
              "estimated_amount": 3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3,
              "estimated_amount": 3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.51
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.09
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 62.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3,
              "estimated_amount": 3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3,
              "estimated_amount": 3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3,
              "estimated_amount": 3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3,
              "estimated_amount": 3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.09
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 46.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3,
              "estimated_amount": 3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 59.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 62.57
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.57,
              "estimated_amount": 2.57
            }
          ],
          "minimum": 1.6,
          "maximum": 3
        }
      ]
    },
    {
      "description": "DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-36962",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.05,
          "discounted_cash": 4.58,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.78
            }
          ]
        }
      ]
    },
    {
      "description": "HYDROCHLOROTHIAZIDE 25 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-3720",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.1,
          "discounted_cash": 3.31,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.83
            }
          ]
        }
      ]
    },
    {
      "description": "HYDROCORTISONE 1 % TOPICAL CREAM",
      "drug_information": {
        "unit": "30",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-3726",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.2,
          "discounted_cash": 0.78,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            }
          ]
        }
      ]
    },
    {
      "description": "HYDROMORPHONE 2 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-3760",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.4,
          "discounted_cash": 6.11,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.99
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.71
            }
          ]
        }
      ]
    },
    {
      "description": "CETUXIMAB 100 MG/50 ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "50",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-37989",
          "type": "CDM"
        },
        {
          "code": "J9055",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3341.7,
          "discounted_cash": 2172.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2145.37
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2506.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1837.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2175.45
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2840.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2840.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2770.27
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2840.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2049.6,
              "estimated_amount": 2049.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2049.6,
              "estimated_amount": 2049.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2840.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1719.67,
              "estimated_amount": 1719.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2840.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2840.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2840.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2145.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1837.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2439.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2049.6,
              "estimated_amount": 2049.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2840.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2049.6,
              "estimated_amount": 2049.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2049.6,
              "estimated_amount": 2049.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2145.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1837.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2439.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2740.19
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2175.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2145.37
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3341.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2049.6,
              "estimated_amount": 2049.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2049.6,
              "estimated_amount": 2049.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2049.6,
              "estimated_amount": 2049.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2840.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2770.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2740.19
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2840.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2175.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2049.6,
              "estimated_amount": 2049.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2049.6,
              "estimated_amount": 2049.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2049.6,
              "estimated_amount": 2049.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2840.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2049.6,
              "estimated_amount": 2049.6
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3341.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2553.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2145.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2111.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1719.67,
              "estimated_amount": 1719.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2740.19
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2145.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2111.95
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 756.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2049.6,
              "estimated_amount": 2049.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2740.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1837.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2049.6,
              "estimated_amount": 2049.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2049.6,
              "estimated_amount": 2049.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2145.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2553.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2553.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2930.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2439.44
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 912.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2175.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2175.45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3341.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2840.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2111.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1837.94
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2940.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2703.44
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2740.19
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2930.67
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2205.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2049.6,
              "estimated_amount": 2049.6
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2840.45
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2506.28
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2439.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1719.67,
              "estimated_amount": 1719.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1719.67,
              "estimated_amount": 1719.67
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2553.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2145.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2145.37
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2840.45
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 731.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2553.06
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3341.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1837.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1837.94
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2740.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2111.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2049.6,
              "estimated_amount": 2049.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2145.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1719.67,
              "estimated_amount": 1719.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2111.95
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2172.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2439.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2439.44
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2703.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2145.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2111.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2111.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2145.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2770.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2740.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2553.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2111.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2506.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 720.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2740.19
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3341.7,
              "additional_payer_notes": "OUTPATIENT"
            }
          ],
          "minimum": 1719.67,
          "maximum": 2049.6
        }
      ]
    },
    {
      "description": "MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-38062",
          "type": "CDM"
        },
        {
          "code": "J7518",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 25.25,
          "discounted_cash": 16.41,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.21
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.93
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.21
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 22.22
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.44
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.96
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 25.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.21
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 22.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.94
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 16.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.43
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 16.41
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.96
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.93
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 20.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.43
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.43
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 22.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.96
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.21
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.21
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.46
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.71
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 20.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.71
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.46
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.71
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.43
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.71
            }
          ]
        }
      ]
    },
    {
      "description": "DEXTROSE 10 % IV BOLUS",
      "drug_information": {
        "unit": "250",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-400302",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 62.95,
          "discounted_cash": 40.92,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.09
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 40.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 40.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 40.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.62
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.95
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.19
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 50.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.09
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 40.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.21
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 62.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 41.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.95
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 55.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 50.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 40.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.53
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 10.9,
          "discounted_cash": 7.08,
          "payers_information": [
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.96
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.56
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.96
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.27
            }
          ]
        }
      ]
    },
    {
      "description": "ISONIAZID 100 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-4026",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.95,
          "discounted_cash": 3.22,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.1
            }
          ]
        }
      ]
    },
    {
      "description": "PEG 400-HYPROMELLOSE-GLYCERIN 1 %-0.2 %-0.2 % EYE DROPS",
      "drug_information": {
        "unit": "15",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-41412",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.1,
          "discounted_cash": 3.31,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.34
            }
          ]
        }
      ]
    },
    {
      "description": "VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-41673",
          "type": "CDM"
        },
        {
          "code": "J9390",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 215.3,
          "discounted_cash": 139.94,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 164.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 164.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.22
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 140.16
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 176.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.07
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 157.17
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.22
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.42
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 99.45,
              "estimated_amount": 99.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 176.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 176.55
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 102.85,
              "estimated_amount": 102.85
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 102.85,
              "estimated_amount": 102.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 157.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.07
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 176.55
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 157.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 140.16
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 99.45,
              "estimated_amount": 99.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 176.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 102.85,
              "estimated_amount": 102.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.01
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 142.1
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 164.49
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 164.49
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 161.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.42
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 161.48
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 189.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.22
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 188.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 161.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 178.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 188.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 99.45,
              "estimated_amount": 99.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 178.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 140.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 174.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 102.85,
              "estimated_amount": 102.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 102.85,
              "estimated_amount": 102.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 102.85,
              "estimated_amount": 102.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 102.85,
              "estimated_amount": 102.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 176.55
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 139.95
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 140.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 102.85,
              "estimated_amount": 102.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 102.85,
              "estimated_amount": 102.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 102.85,
              "estimated_amount": 102.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 157.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 176.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 102.85,
              "estimated_amount": 102.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.22
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 178.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 102.85,
              "estimated_amount": 102.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 102.85,
              "estimated_amount": 102.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 99.45,
              "estimated_amount": 99.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 157.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 102.85,
              "estimated_amount": 102.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 176.55
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 102.85,
              "estimated_amount": 102.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 157.17
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 58.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 174.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 164.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 140.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 102.85,
              "estimated_amount": 102.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 102.85,
              "estimated_amount": 102.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 164.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 99.45,
              "estimated_amount": 99.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 215.3,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 99.45,
          "maximum": 102.85
        }
      ]
    },
    {
      "description": "KETAMINE 10 MG/ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "20",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-4236",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 105.6,
          "discounted_cash": 68.64,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 87.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 68.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 68.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 80.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 66.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 68.53
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 79.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 77.09
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.76
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 79.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.8
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 68.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 66.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 80.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 85.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 87.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 77.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 68.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 80.68
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 66.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 87.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 66.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 80.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 105.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 58.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 77.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 77.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 80.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 66.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 80.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 66.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 77.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 68.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 68.53
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 77.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 92.61
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 79.2
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 69.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 58.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 68.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 68.75
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 28.83
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 92.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 66.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 66.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 58.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 85.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 89.76
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 105.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 58.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 68.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 92.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 86.59
            }
          ]
        }
      ]
    },
    {
      "description": "LACTATED RINGERS INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "1000",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-4318",
          "type": "CDM"
        },
        {
          "code": "J7120",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 67.15,
          "discounted_cash": 43.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.69,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.56,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.56,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 58.89
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.56,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 58.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 43.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 59.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.69,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 54.32
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.67
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.56,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.56,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.56,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.69,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.56,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 18.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.56,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.56,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.56,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.69,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 54.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.56,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.56,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 44.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.56,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.56,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.56,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.67
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.69,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.56,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.56,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OUTPATIENT"
            }
          ],
          "minimum": 5.69,
          "maximum": 6.56
        }
      ]
    },
    {
      "description": "VANCOMYCIN 2000 MG IN D5W 500 ML IVPB",
      "drug_information": {
        "unit": "500",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441029",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 197.65,
          "discounted_cash": 128.47,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 126.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 173.34
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 163.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 159.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 144.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 124.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 126.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 151
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 148.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 151
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 124.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 144.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 128.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 124.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 126.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 126.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 108.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 144.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 162.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 162.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 162.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 128.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 124.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 128.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 144.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 144.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 109.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 151
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 173.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 162.07
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 126.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 124.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 128.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 124.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 108.71
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 128.47
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 151
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 128.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 144.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 109.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 148.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 128.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 124.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 124.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 108.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 108.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 163.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 162.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 124.12
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 163.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 109.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 124.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 124.12
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 108.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 151
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 124.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 126.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 126.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 124.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 124.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 124.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 124.91
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 148.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 108.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 159.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 124.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 124.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 197.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 109.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 162.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 151
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 126.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 124.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 124.91
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 108.71
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 168
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 126.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 124.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 128.27
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 53.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 128.67
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 197.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 126.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 162.07
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 173.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 126.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 126.89
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 130.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 162.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 128.27
            }
          ]
        }
      ]
    },
    {
      "description": "GENTAMICIN FORTIFIED OPH DROPS 14 MG/ML",
      "drug_information": {
        "unit": "7",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441127",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 62.75,
          "discounted_cash": 40.79,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 50.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 40.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 40.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 40.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 40.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.66
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 41.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.46
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.06
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.41
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.85
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 55.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.85
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 40.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 62.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.03
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 50.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.46
            }
          ]
        }
      ]
    },
    {
      "description": "SODIUM CHLORIDE 0.9 % (COLD) INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "1000",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441134",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 67.15,
          "discounted_cash": 43.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 58.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.67
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 43.58
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 54.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 43.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.17
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 59.09
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 37.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 54.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 43.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 37.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 43.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 58.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 43.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 37.27
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 44.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 18.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 37.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            }
          ]
        }
      ]
    },
    {
      "description": "LACTATED RINGERS 500ML +LIDO 1%, SOD BICARB (VENOUS ABLATION) 500 ML",
      "drug_information": {
        "unit": "500",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441204",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 177.3,
          "discounted_cash": 115.24,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 113.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 113.83
            },
            {
              "payer_name": "ANTHEM [335]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 98.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.71
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 150.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 111.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 115.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 113.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 113.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 112.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 111.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.71
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 150.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 129.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 129.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 145.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 155.49
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
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              "standard_charge_percentage": 27.3,
              "estimated_amount": 48.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 112.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 132.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 113.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 111.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 135.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.52
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 115.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 111.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 111.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 177.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 135.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 112.05
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 98.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 115.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 113.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 113.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 135.46
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 112.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 111.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 111.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 112.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 143.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 111.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 146.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 145.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 145.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 135.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.71
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 177.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 145.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 113.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 113.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 115.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 143.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 129.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 145.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 112.05
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 129.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 111.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 115.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 113.83
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 132.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 129.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 145.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 113.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 132.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 115.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 115.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 145.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 112.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 112.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 98.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 135.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 113.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 135.46
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 156.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 115.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 115.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 111.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 115.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 129.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 155.49
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 150.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 111.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 111.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 97.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 146.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 146.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 111.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 145.39
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 117.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 98.4
            }
          ]
        }
      ]
    },
    {
      "description": "PENICILLIN G POT 2.5 MU IN NS 100 ML (CMP PMX)",
      "drug_information": {
        "unit": "100",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441280",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 30.05,
          "discounted_cash": 19.53,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.99
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.53
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 19.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.54
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.54
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.99
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 26.44
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 22.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 19.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.54
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 22.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 30.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.54
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 22.54
            }
          ]
        }
      ]
    },
    {
      "description": "MAGIC MOUTHWASH ORAL SUSPENSION (CMP)",
      "drug_information": {
        "unit": "30",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441303",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11,
          "discounted_cash": 7.15,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.95
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.91
            }
          ]
        }
      ]
    },
    {
      "description": "BUPIV 0.5%, MORPHINE 10MG, METHYLPRED 40MG,NS (PMX) (OP)",
      "drug_information": {
        "unit": "60",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441314",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 187.45,
          "discounted_cash": 121.84,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 120.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 120.34
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 164.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 187.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 151.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 121.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.33
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 51.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.33
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 123.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 120.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 136.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 104.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 121.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 118.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 140.59
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 140.59
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 121.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 164.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 118.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 120.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 118.47
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 122.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 121.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 103.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 120.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 143.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 120.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 153.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 104.03
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 187.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 103.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 153.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 122.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 120.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 118.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 155.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 120.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 122.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 153.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 104.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 121.66
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 143.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 118.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 153.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 136.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 136.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 155.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 120.34
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 118.47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 143.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 122.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 151.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.33
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.33
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 153.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 153.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 103.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 103.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 103.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 118.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 140.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 159.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 120.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 143.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 120.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 164.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 136.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 104.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 118.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 103.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 155.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 143.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 143.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 136.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 153.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 153.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 120.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 122.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 103.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 136.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.72
            }
          ]
        }
      ]
    },
    {
      "description": "CLONIDINE 20 MCG/ML ORAL SUSPENSION",
      "drug_information": {
        "unit": "60",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441315",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.1,
          "discounted_cash": 6.56,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.28
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.28
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            }
          ]
        }
      ]
    },
    {
      "description": "ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT IV KIT (FVIII UNIITS)",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-441331",
          "type": "CDM"
        },
        {
          "code": "J7187",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5151.35,
          "discounted_cash": 3348.38,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3307.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3935.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4378.65
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1406.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4224.11
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3353.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4548,
              "estimated_amount": 4548
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3931.2,
              "estimated_amount": 3931.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3307.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3353.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4378.65
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 927.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3307.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3760.49
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4517.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2833.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4167.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4548,
              "estimated_amount": 4548
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4378.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4378.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4548,
              "estimated_amount": 4548
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3307.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3255.65
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3760.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3931.2,
              "estimated_amount": 3931.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2833.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2833.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4533.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4378.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3935.63
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3255.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3307.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4548,
              "estimated_amount": 4548
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3307.17
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4548,
              "estimated_amount": 4548
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3255.65
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4378.65
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5151.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3307.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3307.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2833.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3255.65
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3760.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3931.2,
              "estimated_amount": 3931.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2833.24
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4548,
              "estimated_amount": 4548
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4378.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3255.65
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3863.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3760.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4224.11
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4378.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4548,
              "estimated_amount": 4548
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4548,
              "estimated_amount": 4548
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3353.53
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 927.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3348.38
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4378.65
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4378.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4270.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4224.11
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4378.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3935.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3307.17
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1128.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4548,
              "estimated_amount": 4548
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3760.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3931.2,
              "estimated_amount": 3931.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4548,
              "estimated_amount": 4548
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3935.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4517.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3255.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2833.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3353.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4548,
              "estimated_amount": 4548
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4548,
              "estimated_amount": 4548
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3863.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4548,
              "estimated_amount": 4548
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4548,
              "estimated_amount": 4548
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3307.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3760.49
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5151.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4167.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4548,
              "estimated_amount": 4548
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3863.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4378.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4548,
              "estimated_amount": 4548
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4224.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4224.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4548,
              "estimated_amount": 4548
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1725.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3399.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3307.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3935.63
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5151.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3353.53
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4378.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2833.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4270.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4224.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4224.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3935.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3255.65
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3255.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3931.2,
              "estimated_amount": 3931.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4270.47
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4224.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3307.17
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1642.87,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4378.65
            }
          ],
          "minimum": 3931.2,
          "maximum": 4548
        }
      ]
    },
    {
      "description": "PENICILLIN VK (DOSE 1) ORAL DESENSITIZATION",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441387",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11.6,
          "discounted_cash": 7.54,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.45
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.51
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.51
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.38
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 10.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.47
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.33
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.45
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 11.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.33
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.51
            }
          ]
        }
      ]
    },
    {
      "description": "PENICILLIN VK (DOSE 3) ORAL DESENSITIZATION",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441389",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11.55,
          "discounted_cash": 7.51,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.42
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.35
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 10.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.57
            }
          ]
        }
      ]
    },
    {
      "description": "PENICILLIN VK (DOSE 7) ORAL DESENSITIZATION",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441393",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11.3,
          "discounted_cash": 7.34,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.61
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.37
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.61
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.61
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.33
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 11.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.61
            }
          ]
        }
      ]
    },
    {
      "description": "OUTSOURCED NON STANDARD FORMULATION BUILDER",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-441735",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 32.9,
          "discounted_cash": 21.38,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.12
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 8.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 27.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 27.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 26.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 26.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 26.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 28.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.97
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 21.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 24.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 24.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 26.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.79
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 26.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.12
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 32.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 28.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 26.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 26.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.79
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.02
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 26.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 21.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 21.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 28.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 24.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.97
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 21.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 27.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 26.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 27.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 26.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 21.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 32.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.02
            }
          ]
        }
      ]
    },
    {
      "description": "TRANEXAMIC ACID 500MG(100 MG/ML) SOLUTION FOR INHALATION",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441826",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 43.6,
          "discounted_cash": 28.34,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 24.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 24.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 35.27
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.99
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.06
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 28.3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 28.34
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 24.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 24.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.56
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 38.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 38.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 28.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 28.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 38.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 43.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 11.9
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 35.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 28.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.75
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 28.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.7
            }
          ]
        }
      ]
    },
    {
      "description": "AMOXICILLIN 250 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-450",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.75,
          "discounted_cash": 3.09,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.09
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.09
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.63
            }
          ]
        }
      ]
    },
    {
      "description": "LOXAPINE SUCCINATE 5 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-4601",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.45,
          "discounted_cash": 3.54,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.02
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            }
          ]
        }
      ]
    },
    {
      "description": "DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SORD",
      "drug_information": {
        "unit": "0.5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-461080",
          "type": "CDM"
        },
        {
          "code": "J1100",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 36.65,
          "discounted_cash": 23.82,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 29.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.4,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 23.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.16
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 24.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.4,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.16
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.4,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.49
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.9,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 30.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.86
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 30.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 30.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 32.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.86
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.4,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.4,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 10.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.16
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 29.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.49
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.15
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.65,
              "additional_payer_notes": "OUTPATIENT"
            }
          ],
          "minimum": 0.9,
          "maximum": 1.5
        }
      ]
    },
    {
      "description": "INV SODIUM CHLORIDE 0.9% INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "1000",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-491017",
          "type": "CDM"
        },
        {
          "code": "25600001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.65,
          "discounted_cash": 0.42,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            }
          ]
        }
      ]
    },
    {
      "description": "INV CABOZANTINIB 60 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-491499",
          "type": "CDM"
        },
        {
          "code": "25600001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.65,
          "discounted_cash": 0.42,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            }
          ]
        }
      ]
    },
    {
      "description": "MICONAZOLE NITRATE 2 % VAGINAL CREAM",
      "drug_information": {
        "unit": "45",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-5040",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 25.8,
          "discounted_cash": 16.77,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.71
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 21.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.8
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.71
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 25.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.83
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 20.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 25.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.93
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14.32
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 21.39
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 7.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.56
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 22.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 20.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.71
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 21.39
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 16.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.31
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 17.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.93
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 19.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.2
            }
          ]
        }
      ]
    },
    {
      "description": "MINOXIDIL 2.5 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-5115",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.25,
          "discounted_cash": 3.41,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
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              "standard_charge_percentage": 66,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.42
            }
          ]
        }
      ]
    },
    {
      "description": "POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "15",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-6451",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 101.55,
          "discounted_cash": 66.01,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 64.18
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 65.91
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 83.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 89.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.77
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 89.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 76.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 64.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 74.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 64.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 64.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 74.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 66.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.32
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.58
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 66.11
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 101.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 64.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 65.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 74.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 83.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 83.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 64.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 74.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 101.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 82.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 89.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 74.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 83.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 76.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 83.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 65.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 82.15
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.32
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 86.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.58
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 66.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 83.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 74.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 66.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 66.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 84.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 83.27
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 67.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.2
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 27.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 65.91
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 76.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 84.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 83.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 66.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 65.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 64.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 64.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 56.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 84.18
            }
          ]
        }
      ]
    },
    {
      "description": "PRAZOSIN 5 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-6470",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 14.75,
          "discounted_cash": 9.59,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 12.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.54
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.23
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.11
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 9.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 9.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 9.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.27
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 14.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 14.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 9.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.11
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 12.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 12.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 9.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 9.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.27
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.6
            }
          ]
        }
      ]
    },
    {
      "description": "PROPRANOLOL 40 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-6658",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6,
          "discounted_cash": 3.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            }
          ]
        }
      ]
    },
    {
      "description": "POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-70284",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8,
          "discounted_cash": 5.2,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            }
          ]
        }
      ]
    },
    {
      "description": "RANOLAZINE ER 500 MG TABLET,EXTENDED RELEASE,12 HR",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-70434",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.95,
          "discounted_cash": 5.17,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.52
            }
          ]
        }
      ]
    },
    {
      "description": "SODIUM POLYSTYRENE SULFONATE ORAL POWDER",
      "drug_information": {
        "unit": "15",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-7356",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 40.8,
          "discounted_cash": 26.52,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.17
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 35.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.68
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 35.9
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.56
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 11.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 26.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 33.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 26.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.44
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 26.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 35.78
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 26.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 26.48
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 40.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 33.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 26.48
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.68
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.68
            }
          ]
        }
      ]
    },
    {
      "description": "MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-78310",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 29.15,
          "discounted_cash": 18.95,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.71
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 18.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.31
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 7.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 25.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.42
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 18.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.27
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 18.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 18.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.9
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 25.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 25.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 18.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.27
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 19.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.31
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.9
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 23.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 23.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.42
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21.86
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.42
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.31
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 29.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.03
            }
          ]
        }
      ]
    },
    {
      "description": "TRIFLUOPERAZINE 5 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-8164",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.65,
          "discounted_cash": 4.32,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.83
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            }
          ]
        }
      ]
    },
    {
      "description": "CLINDAMYCIN 150 MG/ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "2",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-82301",
          "type": "CDM"
        },
        {
          "code": "J0736",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 44.5,
          "discounted_cash": 28.92,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.48,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 39.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.49
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.97
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.48,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44.5,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.48,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.49
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.48,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.48,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.48,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.48
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.48,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 39.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.31,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.31,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.48
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.48,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.31,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.48,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.48
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33.38
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.57
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.48,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.48,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.31,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 39.03
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.48,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.48,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.48,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 28.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.12
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 29.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.48,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 12.15
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.48,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.48,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.31,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.97
            }
          ],
          "minimum": 5.31,
          "maximum": 6.48
        }
      ]
    },
    {
      "description": "FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-88011",
          "type": "CDM"
        },
        {
          "code": "Q2009",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 69.2,
          "discounted_cash": 44.98,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 55.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.32,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.32,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.32,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.32,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.06
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 51.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 57.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.85,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.73
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 45.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.32,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 57.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.32,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.32,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 51.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.85,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.85,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.32,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.32,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 55.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.32,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.32,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.85,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 18.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 44.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.32,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 60.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.32,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.06
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 69.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.85,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 57.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.32,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.32,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.32,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 51.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.32,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 60.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.73
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 60.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            }
          ],
          "minimum": 5.85,
          "maximum": 8.32
        }
      ]
    },
    {
      "description": "ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-8880",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.2,
          "discounted_cash": 0.13,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.13
            }
          ]
        }
      ]
    },
    {
      "description": "IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "2",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-91055",
          "type": "CDM"
        },
        {
          "code": "J9206",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 132.15,
          "discounted_cash": 85.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.56,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 100.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.36
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.33
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.33
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 85.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.84
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.56,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.56,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 100.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 99.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 106.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.33
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 100.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.56,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.47
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.68
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.33
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.56,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 100.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.36
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.33
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 100.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.56,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 109.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.56,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 109.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.56,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.56,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.52
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.56,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.84
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.84
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 100.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.84
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.56,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.56,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.68
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.56,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.56,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.68
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.56,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.84
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 99.11
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 36.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 115.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 106.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 86.03
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.56,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.56,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.43,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.52
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 87.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.84
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 99.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 109.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 115.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.33
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.52
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 116.29
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.15,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 13.56,
          "maximum": 16.43
        }
      ]
    },
    {
      "description": "BUPROPION HCL 100 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-9321",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.8,
          "discounted_cash": 5.07,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.96
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.08
            }
          ]
        }
      ]
    },
    {
      "description": "CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "0.5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-9347",
          "type": "CDM"
        },
        {
          "code": "J0630",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 921.05,
          "discounted_cash": 598.68,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 703.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 807.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 763.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2905.04,
              "estimated_amount": 2905.04
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 782.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 763.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 591.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 506.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2905.04,
              "estimated_amount": 2905.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2578.07,
              "estimated_amount": 921.05
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 782.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 591.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 807.76
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 810.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 582.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2905.04,
              "estimated_amount": 2905.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 591.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 599.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 755.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 599.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2905.04,
              "estimated_amount": 2905.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 506.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 782.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 755.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 591.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 591.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 690.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2905.04,
              "estimated_amount": 2905.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2905.04,
              "estimated_amount": 2905.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 582.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 672.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2905.04,
              "estimated_amount": 2905.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 703.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2578.07,
              "estimated_amount": 921.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 755.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 582.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 582.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 599.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 745.13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 782.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2905.04,
              "estimated_amount": 2905.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 672.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2905.04,
              "estimated_amount": 2905.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 506.58
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 690.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2578.07,
              "estimated_amount": 921.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 755.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 703.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 782.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 582.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 582.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2905.04,
              "estimated_amount": 2905.04
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 782.89
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 782.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 782.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 672.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2578.07,
              "estimated_amount": 921.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 763.55
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 251.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 599.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 591.31
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 607.89
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 598.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 755.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 755.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2905.04,
              "estimated_amount": 2905.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 591.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 703.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 672.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 506.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 672.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 672.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 591.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 782.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 782.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 591.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 591.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 690.79
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 782.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 599.6
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 921.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 582.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 745.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 703.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2905.04,
              "estimated_amount": 2905.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2905.04,
              "estimated_amount": 2905.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 506.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 755.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2905.04,
              "estimated_amount": 2905.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2905.04,
              "estimated_amount": 2905.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2905.04,
              "estimated_amount": 2905.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 506.58
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 782.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 703.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 755.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 591.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 591.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2578.07,
              "estimated_amount": 921.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2905.04,
              "estimated_amount": 2905.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 582.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 506.58
            }
          ],
          "minimum": 2578.07,
          "maximum": 2905.04
        }
      ]
    },
    {
      "description": "COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION",
      "drug_information": {
        "unit": ".67",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-9681",
          "type": "CDM"
        },
        {
          "code": "J0770",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 48.9,
          "discounted_cash": 31.78,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.28,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.36
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 13.35
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.28,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 42.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 43.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.28,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 48.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 36.68
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.28,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.05,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 39.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.28,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.28,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.05,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.28,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.05,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.28,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.28,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.28,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.28,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.05,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.05,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.28,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 32.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 40.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.28,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 40.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 31.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.28,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.28,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.28,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 33.28,
              "estimated_amount": 33.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 36.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 42.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 40.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 39.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 36.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.9
            }
          ],
          "minimum": 30.05,
          "maximum": 33.28
        }
      ]
    },
    {
      "description": "ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET",
      "drug_information": {
        "unit": "4",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-96948",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 69.6,
          "discounted_cash": 45.24,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.68
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.16
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 45.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 38.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 69.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 52.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 38.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 57.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 69.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 57.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 38.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 52.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.81
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 61.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.16
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.99
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 45.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.99
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 52.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.99
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 56.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 45.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 56.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 61.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 45.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 61.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 38.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.17
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 45.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 45.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 57.7
            }
          ]
        }
      ]
    },
    {
      "description": "MILNACIPRAN 12.5 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-97087",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 28.15,
          "discounted_cash": 18.3,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 21.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 17.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.79
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 21.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 15.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 15.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 17.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 17.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.33
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21.11
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 18.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 28.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 22.77
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.93
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 17.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 15.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 23.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 17.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.79
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 28.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 24.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.79
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 24.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 17.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 18.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 17.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 21.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 21.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 17.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 21.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 17.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.48
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 24.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 22.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 17.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 23.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 17.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 17.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.48
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 18.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 15.62
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 18.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 18.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 18.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 17.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 15.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 20.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 23.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 18.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 21.51
            }
          ]
        }
      ]
    },
    {
      "description": "DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "1000",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-9815",
          "type": "CDM"
        },
        {
          "code": "J7042",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 67.15,
          "discounted_cash": 43.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 37.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 54.32
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.36
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 54.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 58.89
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 37.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 18.33
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 37.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 67.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.3
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 44.32
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 58.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 37.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 59.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.06
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 43.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.11
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.71
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 67.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.08
            }
          ]
        }
      ]
    },
    {
      "description": "DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-9902",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 18.7,
          "discounted_cash": 12.15,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 16.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15.33
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.29
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.29
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 12.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 16.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 12.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 12.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 14.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 14.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.9
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 18.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 14.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 12.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10.38
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 12.16
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 15.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.9
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 16.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.17
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 14.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 14.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.74
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 5.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 18.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15.33
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 14.29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 15.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 15.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14.03
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 12.14
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.17
            }
          ]
        }
      ]
    },
    {
      "description": "OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-99610",
          "type": "CDM"
        },
        {
          "code": "J9263",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 120.7,
          "discounted_cash": 78.45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.28
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 98.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16,
              "estimated_amount": 16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16,
              "estimated_amount": 16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 78.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.49
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16,
              "estimated_amount": 16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.38,
              "estimated_amount": 16.38
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 105.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.11
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 32.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.6
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.38,
              "estimated_amount": 16.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 98.97
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16,
              "estimated_amount": 16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16,
              "estimated_amount": 16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16,
              "estimated_amount": 16
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.49
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16,
              "estimated_amount": 16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16,
              "estimated_amount": 16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16,
              "estimated_amount": 16
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 90.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 105.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 90.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16,
              "estimated_amount": 16
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 98.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 97.65
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.39
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 78.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16,
              "estimated_amount": 16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16,
              "estimated_amount": 16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 100.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 100.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16,
              "estimated_amount": 16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16,
              "estimated_amount": 16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.21
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 106.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.39
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 78.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.49
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 98.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16,
              "estimated_amount": 16
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 90.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 98.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 98.97
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 98.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.6
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 78.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 98.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16,
              "estimated_amount": 16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 100.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 78.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 97.65
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.49
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.38,
              "estimated_amount": 16.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.38,
              "estimated_amount": 16.38
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.39
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 79.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.6
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 120.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16,
              "estimated_amount": 16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.38,
              "estimated_amount": 16.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 78.58
            }
          ],
          "minimum": 16,
          "maximum": 16.38
        }
      ]
    },
    {
      "description": "GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-99835",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.75,
          "discounted_cash": 4.39,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.24
            }
          ]
        }
      ]
    },
    {
      "description": "TROCAR 5 X 75MM BLADELESS XCEL W/OPTIVIEW",
      "code_information": [
        {
          "code": "SUP-2B5ST",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 57.86,
          "discounted_cash": 37.61,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.15
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 32.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 46.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 47.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 37.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 37.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 44.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.18
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 50.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 43.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 50.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 44.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 42.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 42.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 42.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 57.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 44.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 50.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 44.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 42.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 43.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 46.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.15
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 32.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 43.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 44.21
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 37.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.18
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 38.19
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 57.86,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.15
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 47.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 47.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 42.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 42.24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 44.21
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 32.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 32.11
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 37.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 37.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.18
            }
          ]
        }
      ]
    },
    {
      "description": "CARTRIDGE 100MM LINEAR RELOAD UNIT",
      "code_information": [
        {
          "code": "SUP-TCR10",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 270.3,
          "discounted_cash": 175.69,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 206.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 150.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.53
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 150.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 270.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.53
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 175.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 175.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 224.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 175.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 237.05
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 202.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 206.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 175.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 206.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 218.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 175.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 175.97
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 175.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 175.97
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 224.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 224.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 202.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 202.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 206.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 206.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 237.05
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 237.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 218.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.67
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 150.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.83
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 175.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.67
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 150.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.67
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 270.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 73.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 206.51
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 178.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 175.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.75
            }
          ]
        }
      ]
    },
    {
      "description": "CARTRIDGE 45MM RELOAD MED CVD TIP TAN",
      "code_information": [
        {
          "code": "SUP-SIG45CTAVM",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 545,
          "discounted_cash": 354.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 344.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 354.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 344.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 397.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 408.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 451.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 342.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 416.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 344.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 344.44
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 354.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 342.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 451.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 446.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 477.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 342.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 299.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 446.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 416.38
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 479.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 302.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 408.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 545
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 353.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 299.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 397.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 302.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 451.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 440.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 353.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 446.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 354.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 342.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 344.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 344.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 416.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 416.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 342.26
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 408.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 397.85
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 545,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 342.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 342.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 344.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 342.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 353.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 299.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 446.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 302.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 354.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 397.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 446.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 342.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 342.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 299.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 416.38
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 353.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 359.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 354.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 299.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 302.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 342.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 416.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 299.75
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 354.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 148.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 397.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 477.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 342.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 299.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 397.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 446.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 446.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 440.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 344.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 342.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 446.9
            }
          ]
        }
      ]
    },
    {
      "description": "CARTRIDGE 6-CLIP ABSORBABLE LAPRA-TY",
      "code_information": [
        {
          "code": "SUP-XC200",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 186.44,
          "discounted_cash": 121.19,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 142.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 102.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 102.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 152.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 152.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 152.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 139.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 119.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 119.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 103.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 163.51
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 142.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 121
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 50.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 152.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 121.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 136.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 152.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 121.37
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 139.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 152.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 119.69
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 136.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 103.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 136.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 154.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 152.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 150.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 119.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 102.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 136.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 117.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 117.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 117.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 119.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 119.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 121
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 121.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 119.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 136.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 117.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 154.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 121.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 163.51
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 103.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 119.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 119.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 119.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 142.44
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 142.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 102.54
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 186.44,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 142.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 117.83
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 164.07
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 154.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 121
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 117.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 102.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 136.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 119.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 121
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 103.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 142.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 121.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 139.83
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 123.05
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 121.19
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 117.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 102.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 102.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 152.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 117.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 119.69
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 158.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 150.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 117.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 186.44
            }
          ]
        }
      ]
    },
    {
      "description": "TUBE 20FR PEG SAFETY PUSH METHOD OTW MIC KIT",
      "code_information": [
        {
          "code": "SUP-7170-20",
          "type": "CDM"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 270,
          "discounted_cash": 175.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 206.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 175.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.56
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 202.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 175.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 175.23
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 218.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 223.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 149.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 223.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.4
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 73.71
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 149.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 206.28
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 270,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.1
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 178.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 175.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 270
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 175.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 206.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 236.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 175.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.56
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 175.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 206.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 197.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 175.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 149.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.5
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 237.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 175.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 202.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 148.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 223.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 175.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 149.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 206.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 236.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 218.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 169.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 221.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 229.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 206.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 173.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 202.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 170.64
            }
          ]
        }
      ]
    },
    {
      "description": "CATH 10FR HEYMAN FOLLOWER",
      "code_information": [
        {
          "code": "SUP-021110",
          "type": "CDM"
        },
        {
          "code": "C1729",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 24.17,
          "discounted_cash": 15.71,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.73
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.41
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 15.71
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.52
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.13
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 6.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 21.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.29
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 21.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.64
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.52
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.28
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 21.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.47
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 24.17
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.52
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.47
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.29
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 24.17,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "LEAD 1 X 8 TRIAL MRI COMPACT SURESCAN",
      "code_information": [
        {
          "code": "SUP-977D260",
          "type": "CDM"
        },
        {
          "code": "C1897",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1986,
          "discounted_cash": 1290.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1273.03
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 434.93
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1628.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1273.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1211.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1211.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1300.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1269.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1688.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1517.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1273.03
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1300.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1292.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1606.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1211.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1269.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1092.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1211.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1273.03
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1688.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1211.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1688.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1092.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1273.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1300.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1688.1
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1292.89
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 542.18
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1688.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1449.78
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1646.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1628.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1688.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1489.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1517.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1628.52
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1489.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1606.67
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1986
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1688.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1102.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1449.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1628.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1211.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1449.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1102.23
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1449.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1646.39
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1211.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1273.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1092.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1646.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1628.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1292.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1517.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1092.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1688.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1688.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1628.52
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1688.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1741.72
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1628.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1300.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1300.83
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1517.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1092.3
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1092.3
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1489.5
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1310.76
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1290.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1300.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1300.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1741.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1211.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1269.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1292.89
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1300.83
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1688.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1688.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1449.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1628.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1292.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1517.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1273.03
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1102.23
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1747.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1273.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1273.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1688.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1211.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1211.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1211.46
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1273.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1517.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1102.23
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1986,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1273.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1269.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1211.46
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1688.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1092.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1273.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1211.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1449.78
            }
          ]
        }
      ]
    },
    {
      "description": "CLEANER 2-STEP WOUND DEBRIDEMENT 0.05 CHG IRRISEPT SYSTEM",
      "code_information": [
        {
          "code": "SUP-ISEPT-450-USA",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 210,
          "discounted_cash": 136.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 115.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 210,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 160.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 153.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 116.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 136.5
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 184.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 153.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 116.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 115.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 115.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 160.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 174.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 160.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 169.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 157.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 115.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 184.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 174.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 184.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 160.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 160.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 136.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 136.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 136.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 136.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 115.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 136.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 157.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 157.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 153.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 116.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 115.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 115.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 153.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 160.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 153.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 153.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 174.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 136.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 169.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 136.29
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 57.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.72
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 136.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 210
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 136.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 138.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 116.55
            }
          ]
        }
      ]
    },
    {
      "description": "NAIL 12 X 170MM 130DEG FEM SHORT CANN TI STERL TFNA",
      "code_information": [
        {
          "code": "SUP-04.037.242S",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4294.8,
          "discounted_cash": 2791.62,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3281.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2383.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2619.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2619.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3766.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2744.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2362.14
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3650.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2619.83
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3650.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3650.58
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3221.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2752.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2752.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3135.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3521.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3221.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3521.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2362.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2362.14
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3650.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2619.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2619.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4294.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3281.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3521.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2813.09
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2834.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2619.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2619.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3650.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3135.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3560.39
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3650.58
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3650.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2619.83
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2752.97
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2362.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3135.2
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2813.09
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3650.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3281.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2362.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3650.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2752.97
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2383.61
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2752.97
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3650.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2813.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3281.23
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2619.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2362.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3650.58
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1172.48
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3135.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2795.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2752.97
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3650.58
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3650.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2744.38
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3560.39
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2813.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2813.09
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2791.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3560.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3521.74
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2752.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2795.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3521.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2813.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2813.09
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 3779.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2619.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2744.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2752.97
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3221.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2619.83
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2813.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2752.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3521.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2752.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2795.91
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 940.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2752.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2362.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2383.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2383.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2795.91
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2619.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2744.38
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3281.23
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2619.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3474.49
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4294.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3766.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2752.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3281.23
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3650.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3135.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3521.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3521.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3135.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2795.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3474.49
            }
          ]
        }
      ]
    },
    {
      "description": "NEUROSTIMULATOR EXTERNAL ENS MODEL 3531 W/BELT DISP VERIFY",
      "code_information": [
        {
          "code": "SUP-353101",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 927,
          "discounted_cash": 602.55,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 708.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 585.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 760.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 749.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 509.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 927
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 760.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 595.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 787.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 601.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 787.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 509.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 514.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 760.14
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 611.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 582.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 582.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 582.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 509.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 595.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 595.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 676.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 676.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 708.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 595.13
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 787.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 582.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 787.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 603.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 585.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 585.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 676.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 595.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 760.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 749.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 768.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 585.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 812.98
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 695.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 601.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 603.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 603.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 509.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 676.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 676.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 676.71
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 602.55
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 787.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 595.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 708.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 582.16
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 253.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 595.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 595.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 582.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 582.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 585.86
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 787.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 708.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 582.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 760.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 708.23
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 787.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 787.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 509.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 585.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 760.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 603.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 603.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 582.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 514.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 582.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 787.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 695.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 582.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 812.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 768.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 760.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 787.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 514.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 585.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 582.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 509.85
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 927,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 595.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 708.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 601.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 514.49
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 815.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 695.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 601.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 760.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 585.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 582.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 509.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 595.13
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 787.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 595.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 787.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 768.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 595.13
            }
          ]
        }
      ]
    },
    {
      "description": "SEALANT 4ML PLEURAL AIR LEAK PROGEL STERL",
      "code_information": [
        {
          "code": "SUP-PGPS002",
          "type": "CDM"
        },
        {
          "code": "C9250",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1587.6,
          "discounted_cash": 1031.94,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1212.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1019.24
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 433.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1003.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1003.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1301.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 374.82,
              "estimated_amount": 374.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 374.82,
              "estimated_amount": 374.82
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1587.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 374.82,
              "estimated_amount": 374.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1349.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1316.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1301.83
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 374.82,
              "estimated_amount": 374.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1212.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1019.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1284.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 374.82,
              "estimated_amount": 374.82
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 374.82,
              "estimated_amount": 374.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 374.82,
              "estimated_amount": 374.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1019.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1158.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1301.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1587.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1587.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1392.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 873.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1349.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 374.82,
              "estimated_amount": 374.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1003.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1190.7
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 347.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1033.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1158.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 374.82,
              "estimated_amount": 374.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1349.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1158.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1003.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1212.93
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1587.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 873.18
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1019.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1019.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1349.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 374.82,
              "estimated_amount": 374.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1587.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 374.82,
              "estimated_amount": 374.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 374.82,
              "estimated_amount": 374.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 873.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1392.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1019.24
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1158.95
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1158.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1033.53
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 873.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1003.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1003.36
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1019.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1212.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1003.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 374.82,
              "estimated_amount": 374.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 374.82,
              "estimated_amount": 374.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1316.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1033.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1301.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1019.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1190.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1587.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1284.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 374.82,
              "estimated_amount": 374.82
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1587.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1019.24
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1349.46
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1349.46
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1397.09
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1587.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1349.46
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 139.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1031.94
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1349.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1301.83
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 873.18
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1587.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1190.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1212.93
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1349.46
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1349.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1158.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1019.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1212.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1349.46
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1349.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1301.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1003.36
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 873.18
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1349.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 374.82,
              "estimated_amount": 374.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1019.24
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1349.46
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1047.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1316.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1301.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1033.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1019.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1587.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 374.82,
              "estimated_amount": 374.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1301.83
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 132.92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 873.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1033.53
            }
          ],
          "minimum": 374.82,
          "maximum": 374.82
        }
      ]
    },
    {
      "description": "BIT 3.1MM DRILL PERIPHERAL SCREW STERL DISP",
      "code_information": [
        {
          "code": "SUP-5901-1126",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 215.73,
          "discounted_cash": 140.22,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 164.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 135.48
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 215.73,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 140.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 176.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 164.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 157.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 189.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 164.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 157.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 215.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 135.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 135.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 161.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 176.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 140.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 174.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 157.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 176.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 140.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 176.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 164.82
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 161.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 157.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 119.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 135.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 176.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 176.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 135.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.34
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 189.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 135.48
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 140.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 189.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 157.48
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 142.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 140.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 135.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 135.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 135.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 140.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 164.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 119.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.34
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 135.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 140.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 140.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 178.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 176.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 119.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 178.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 140.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 135.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 135.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 140.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 161.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 119.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 138.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 164.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 157.48
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 58.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 135.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 136.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 183.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 178.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 176.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 118.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 174.53
            }
          ]
        }
      ]
    },
    {
      "description": "COMPONENT 65MM LT DIST FEM STD GMRS",
      "code_information": [
        {
          "code": "SUP-6495-2-030",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 17319,
          "discounted_cash": 11257.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13231.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10564.59
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 3117.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10564.59
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14721.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9612.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14721.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14011.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11101.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11274.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9525.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11101.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13231.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14011.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15188.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11101.48
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9612.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9612.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14201.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14201.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11274.67
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11343.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 11066.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13231.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10564.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9525.45
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14721.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12642.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13231.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14721.15
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11101.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14201.58
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15188.76
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12989.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10564.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10564.59
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 3117.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9525.45
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 11257.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11343.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11343.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11101.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10564.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14357.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14201.58
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14721.15
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9525.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12642.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12642.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11101.48
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 11430.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11101.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10564.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11343.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11343.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14721.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14721.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14201.58
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14201.58
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14721.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9525.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 17319
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9612.05
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13231.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11343.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12642.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14357.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14201.58
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4728.09
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10564.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9525.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11101.48
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14721.15
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14721.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10564.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10564.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11101.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11101.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13231.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12989.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11343.95
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 3792.86
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11274.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 11066.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14721.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11274.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10564.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11343.95
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12989.25
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14721.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10564.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14357.45
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 15240.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 11066.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12642.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11274.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14201.58
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14721.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9525.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 11066.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11101.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12642.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11101.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10564.59
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14721.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17319,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "KIT KNEE SUBCHONDROPLASTY COMPLETE END-DELIVERY ACCUPORT",
      "code_information": [
        {
          "code": "SUP-414.503",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10875,
          "discounted_cash": 7068.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8308.5
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7177.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7123.13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9243.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6949.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5981.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9015.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7079.63
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9243.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5981.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6970.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8917.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7123.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7938.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7079.63
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6633.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5981.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9243.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7938.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8917.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7123.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5981.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5981.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9243.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6949.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8917.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6970.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8156.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6633.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6633.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6035.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8917.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6949.13
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6035.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9015.38
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9537.38
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5981.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8308.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9537.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6949.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8797.88
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 7068.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7079.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7938.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6633.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5981.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7123.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7123.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6970.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8797.88
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9243.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6633.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8156.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7123.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6633.75
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9243.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9243.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10875
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7938.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6633.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9243.75
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2968.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9243.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9243.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7079.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8308.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9243.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8156.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7938.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8917.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7079.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8308.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1957.5
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9243.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6633.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6633.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9243.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6035.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6970.88
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7123.13
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 2381.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6970.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6633.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8917.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6633.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6633.75
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6970.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6970.88
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1957.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8917.5
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8917.5
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9570
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8308.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6633.75
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6035.63
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6970.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6970.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6970.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8308.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7938.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9243.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6970.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6970.88
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7123.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9015.38
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10875,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "STAPLER 12MM UNIVERSAL ULTRA XL",
      "code_information": [
        {
          "code": "SUP-EGIAUXL",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 435.99,
          "discounted_cash": 283.39,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 279.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 279.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 275.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 282.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 333.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 370.59
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 287.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 333.1
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 119.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 275.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 273.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 357.51
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 370.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 361.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 361.44
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 370.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 273.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 318.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 357.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 382.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 275.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 273.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 282.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 370.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 239.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 333.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 279.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 275.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 279.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 279.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 361.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 273.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 370.59
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 370.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 282.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 279.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 333.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 279.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 318.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 352.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 275.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 279.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 239.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 239.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 370.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 273.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 273.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 273.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 273.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 370.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 382.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 279.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 279.91
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 383.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 273.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 283.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 283.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 318.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 241.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 357.51
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 283.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 357.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 357.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 333.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 273.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 239.79
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 435.99,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 241.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 283.83
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 326.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 333.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 326.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 357.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 357.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 275.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 279.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 273.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 239.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 318.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 241.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 370.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 239.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 241.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 273.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 352.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 275.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 275.55
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 370.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 279.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 370.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 318.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 435.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 357.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 326.99
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 370.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 283.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 318.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 273.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 282.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 239.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 283.83
            }
          ]
        }
      ]
    },
    {
      "description": "BASKET 1.9FR X 11MM X 120CM NITINOL STONE RETRIEVAL DAKOTA",
      "code_information": [
        {
          "code": "SUP-390-501",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 586.92,
          "discounted_cash": 381.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 474.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 368.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 322.81
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 440.19
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 428.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 486.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 481.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 448.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 428.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 486.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 382.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 380.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 322.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 368.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 368.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 448.41
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 380.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 325.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 448.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 481.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 322.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 322.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 486.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 481.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 370.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 370.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 368.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 428.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 370.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 368.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 382.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 382.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 382.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 368.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 448.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 440.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 481.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 448.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 440.19
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 325.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 514.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 428.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 368.59
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 160.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 481.27
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 448.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 368.59
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 586.92,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 428.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 481.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 481.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 382.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 380.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 368.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 325.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 514.73
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 387.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 370.93
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 368.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 322.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 322.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 370.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 481.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 474.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 370.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 368.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 368.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 498.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 322.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 370.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 428.45
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 516.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 586.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 380.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 370.93
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 381.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 325.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 368.59
            }
          ]
        }
      ]
    },
    {
      "description": "SEALER 20CM TISSUE CVD ENSEAL X1 LARGE JAW",
      "code_information": [
        {
          "code": "SUP-NSLX120L",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1455.54,
          "discounted_cash": 946.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 934.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 934.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1193.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1237.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 919.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 800.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1177.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1112.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 934.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 934.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 914.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 800.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1062.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1206.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1193.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 947.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1177.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1455.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1193.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 944.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 946.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 934.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 807.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 914.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1237.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 934.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 934.46
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1237.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 914.08
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1091.66
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 960.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1112.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 919.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1062.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1062.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1193.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 914.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 919.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 944.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 934.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1206.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1193.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 934.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 914.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 914.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 807.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1193.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 947.56
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 397.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 914.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 800.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 800.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 947.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 807.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 919.9
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1280.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1237.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 919.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1112.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1062.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 800.55
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1455.54,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1193.54
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1237.21
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1237.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1112.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 947.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 914.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1237.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1091.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1237.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1112.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1062.54
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1237.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1062.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1276.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 919.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1237.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 947.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1206.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 934.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 944.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 919.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 807.82
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1237.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 914.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 934.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1091.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 944.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 914.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 800.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1112.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1193.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 919.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1276.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 934.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 914.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 914.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 914.08
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1237.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 800.55
            }
          ]
        }
      ]
    },
    {
      "description": "CORD ACTIVE DISP",
      "code_information": [
        {
          "code": "SUP-DAC",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 75.96,
          "discounted_cash": 49.37,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.77
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.57
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 62.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 62.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 42.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.45
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.96,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 66.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 62.29
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 49.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 42.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.45
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 20.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 62.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 62.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 62.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 42.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.01
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 49.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.01
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 50.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 42.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 75.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 62.29
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 66.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.78
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.57
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.01
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 66.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.45
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 62.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.78
            }
          ]
        }
      ]
    },
    {
      "description": "CARTRIDGE 30MM RELOAD CVD TIP GRAY VASCULAR",
      "code_information": [
        {
          "code": "SUP-SIG30CTAV",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1415.59,
          "discounted_cash": 920.13,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 908.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 918.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 888.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 918.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1173.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1160.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 888.99
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1203.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1203.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 894.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1033.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 888.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1203.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 888.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 888.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1081.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 785.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1061.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 888.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1033.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 894.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1160.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 888.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 921.55
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 386.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 894.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1203.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1415.59,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1081.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 778.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 908.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 785.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1160.78
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1203.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1033.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 908.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 908.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 888.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 888.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1203.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1145.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 908.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1081.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1241.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 921.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1081.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1061.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1033.38
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1203.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1203.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 908.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1081.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 908.81
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1061.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 778.57
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1203.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 908.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 888.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1033.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 921.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 888.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1081.51
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 934.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 785.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1160.78
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 920.13
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1245.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 894.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1203.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 894.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 888.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 894.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 908.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 908.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1203.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 778.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 778.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 778.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1173.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1145.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1203.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1241.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 918.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 778.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 785.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 908.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1173.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1160.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1160.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 921.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 778.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 888.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1415.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1160.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 921.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 894.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 908.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1033.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 918.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 894.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1160.78
            }
          ]
        }
      ]
    },
    {
      "description": "STEM 70MM 7DEG ULNAR SM STD LT LATITUDE EV",
      "code_information": [
        {
          "code": "SUP-0030021",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 14025,
          "discounted_cash": 9116.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8990.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8990.03
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8555.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8555.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7713.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11921.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8990.03
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 8961.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8555.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11921.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11921.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10238.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11500.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8555.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7713.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8555.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8555.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8555.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 2524.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10715.1
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7783.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 12299.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10715.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11921.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11921.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8555.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11500.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8555.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10238.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10238.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11626.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 8961.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8990.03
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7713.75
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 3071.48
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11921.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11500.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9130.28
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 12299.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11626.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8990.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10518.75
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 9256.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10715.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9130.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11921.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 9186.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 9186.38
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11921.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11500.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9130.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8990.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11346.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8990.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8990.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10518.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 9186.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8555.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 2524.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7713.75
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 12342
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8555.25
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11921.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7783.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9130.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11921.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7713.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10715.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11921.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8990.03
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11921.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 14025
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 8961.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11500.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11500.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 9186.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8990.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8990.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11626.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11500.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 9186.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8555.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10518.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10715.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10715.1
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7713.75
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 9116.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10238.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11346.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9130.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11921.25
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10238.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7783.88
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 9186.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8990.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10238.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11500.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 9186.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8555.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 8961.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11921.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7713.75
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3828.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 9186.38
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 14025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7783.88
            }
          ]
        }
      ]
    },
    {
      "description": "CAP SM ULNAR LATITUDE EV",
      "code_information": [
        {
          "code": "SUP-DKY067",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2676,
          "discounted_cash": 1739.4,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2044.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1715.32
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 586.04
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2274.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1485.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1709.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1632.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1632.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1709.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1742.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1742.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2346.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1632.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2274.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1742.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2007
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2274.6
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2354.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2218.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1632.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1715.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1715.32
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2274.6
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2274.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1953.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2676
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1752.78
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2274.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1632.36
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2274.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1953.48
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 730.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2346.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2274.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1953.48
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1715.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2007
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2194.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2194.32
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2274.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1715.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2274.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1715.32
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1766.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1709.96
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2274.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1485.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2194.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2218.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1752.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1953.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2194.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2194.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2044.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2194.32
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2194.32
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1632.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1471.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1632.36
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1739.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1752.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1715.32
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2044.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1715.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1632.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1953.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1632.36
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1953.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1752.78
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1471.8
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1715.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1752.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2044.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1752.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1709.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1632.36
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2274.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2007
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2164.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1752.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1471.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1471.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2044.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1715.32
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2274.6
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1485.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2218.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2194.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1742.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1485.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1742.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1632.36
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1715.32
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1632.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1471.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1471.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2274.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1715.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2044.46
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2164.88
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2676,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1752.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1632.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1471.8
            }
          ]
        }
      ]
    },
    {
      "description": "PASSER SUTURE DISP LATITUDE EV",
      "code_information": [
        {
          "code": "SUP-DKY090",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 222,
          "discounted_cash": 144.3,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 142.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 139.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 122.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 122.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 184.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 142.52
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 166.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 142.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 182.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 144.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 139.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 188.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 179.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 194.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 182.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 179.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 142.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 169.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 139.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 144.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 162.06
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 188.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 169.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 122.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 123.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 139.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 139.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 142.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 142.52
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 188.7
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 222,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 140.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 140.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 140.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 169.61
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 146.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 144.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 139.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 123.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 123.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 188.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 162.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 182.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 144.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 142.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 139.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 188.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 122.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 144.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 142.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 169.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 122.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 140.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 166.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 182.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 182.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 142.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 140.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 188.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 140.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 184.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 144.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 139.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 169.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 169.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 144.08
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 166.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 188.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 142.52
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 188.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 140.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 144.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 194.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 142.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 139.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 162.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 162.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 182.04
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 60.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 122.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 140.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 139.42
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 195.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 188.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 144.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 222
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 184.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 182.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 162.06
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 188.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 142.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 122.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 188.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 182.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 144.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 162.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 139.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 139.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 139.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 123.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 188.7
            }
          ]
        }
      ]
    },
    {
      "description": "SPOOL SM HUM CENTERED OFFSET LT LATITUDE EV",
      "code_information": [
        {
          "code": "SUP-DKY212",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6246,
          "discounted_cash": 4059.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4003.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3466.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5121.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5121.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4066.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3810.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5309.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4771.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4771.94
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4003.69
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5309.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3991.19
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5496.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3810.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3810.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4003.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4003.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5121.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4091.13
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4684.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4003.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5477.74
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1124.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3435.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5309.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4771.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3810.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3810.06
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1124.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3435.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4091.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5177.93
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4684.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5309.1
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4066.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5121.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3435.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4559.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6246
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4066.15
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4771.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5121.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4066.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4091.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4091.13
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4559.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4066.15
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5309.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3991.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4559.58
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4091.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3810.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3810.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4091.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5177.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4003.69
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4559.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5121.72
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3435.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5309.1
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3810.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3810.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5309.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4684.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4059.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4003.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5309.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5309.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5177.93
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4771.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4003.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3991.19
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4091.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3810.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5309.1
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4559.58
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5309.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3466.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3435.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5121.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4559.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5053.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5053.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3810.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5309.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3810.06
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4122.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4003.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4003.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4091.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3435.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5477.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4771.94
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3810.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3991.19
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6246,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1705.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3435.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5309.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4003.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3466.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4003.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3466.53
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1367.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5121.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5309.1
            }
          ]
        }
      ]
    },
    {
      "description": "BIT 3MM DRILL DISP AEQUALIS REVERSED",
      "code_information": [
        {
          "code": "SUP-DWD055",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 210,
          "discounted_cash": 136.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 160.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 210
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 136.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 115.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 160.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 136.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 160.44
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 184.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 160.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 169.89
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 153.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 160.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 115.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 153.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 174.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 115.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 115.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 153.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 174.09
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 57.33
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 138.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 136.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 115.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 153.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 136.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 116.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 157.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 136.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 116.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 184.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 157.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 153.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 136.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 160.44
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 136.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 132.72
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 210,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 157.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 153.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 172.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 136.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 178.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 116.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 136.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 115.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 174.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 116.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 136.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 131.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 169.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 184.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 115.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 134.82
            }
          ]
        }
      ]
    },
    {
      "description": "STEM 66MM 1B 132.5DEG HUM STD PTC ASCEND FLEX",
      "code_information": [
        {
          "code": "SUP-DWF601B",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7788,
          "discounted_cash": 5062.2,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4992.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4322.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5069.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4750.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5062.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5685.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4976.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5685.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4750.68
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5841
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4750.68
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1401.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4992.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6386.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5069.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5841
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5101.14
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6619.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6619.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6619.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5101.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4976.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4283.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4992.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5101.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4283.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4992.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4992.11
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6853.44
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1401.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6830.08
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1705.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4322.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4283.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4283.4
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5685.24
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5069.99
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2126.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4283.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4992.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5950.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4992.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4992.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4750.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5101.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4750.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6386.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4992.11
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6619.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6386.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5069.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6456.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6386.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6619.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4992.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4750.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6300.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5950.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5950.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5685.24
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6386.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5685.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7788
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4976.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6386.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6830.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6300.49
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4283.4
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6619.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6619.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4750.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6619.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6619.8
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4322.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4750.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6619.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5101.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5101.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5950.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4992.11
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4976.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4750.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6619.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5841
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4750.68
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6619.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4283.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5950.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5101.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4750.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5685.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4322.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6456.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5069.99
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4750.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6386.16
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7788,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5101.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4750.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4992.11
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5140.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5950.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6386.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6619.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6456.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6619.8
            }
          ]
        }
      ]
    },
    {
      "description": "CUTTER 75MM LINEAR PROXIMATE W/SAFETY LOCKOUT",
      "code_information": [
        {
          "code": "SUP-TLC75",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 333.06,
          "discounted_cash": 216.49,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 276.11
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 333.06,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 216.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 184.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 216.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 209.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 209.16
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 243.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 209.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 183.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 183.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 276.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 292.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 243.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 243.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 184.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 269.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 209.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.1
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 219.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 209.16
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 216.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 184.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 249.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 216.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 216.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 183.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 243.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 216.49
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 243.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 216.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 249.8
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 293.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 276.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 183.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 333.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 183.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 183.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 209.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 183.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.11
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 90.93
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 209.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 216.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 209.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 184.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 209.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 249.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 292.09
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 283.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 243.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 209.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 209.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 209.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 216.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 209.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 269.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 273.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 216.82
            }
          ]
        }
      ]
    },
    {
      "description": "SHEET 35 X 55IN REPOSITIONING NO STRAPS COMFORTGLIDE",
      "code_information": [
        {
          "code": "SUP-CGLIDESHEETNS",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 94.4,
          "discounted_cash": 61.36,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 82.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 61.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 52.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 70.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 78.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 94.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 82.79
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 72.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 94.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 61.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 52.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 52.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 72.12
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 72.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 76.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 61.27
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 70.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 72.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.92
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 61.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 61.27
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 62.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 52.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.66
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.28
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 76.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 70.8
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 78.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 72.12
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 83.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 78.26
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 25.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 72.12
            }
          ]
        }
      ]
    },
    {
      "description": "ANCHOR 1.8MM SUTURE KNOTLESS 2FIBERWIRE CL",
      "code_information": [
        {
          "code": "SUP-AR-3638",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1323,
          "discounted_cash": 859.95,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 848.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 848.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1010.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1124.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 845.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 727.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 861.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1084.86
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 807.03
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 727.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1010.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 848.04
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1124.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1010.77
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1070.31
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 866.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 807.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1084.86
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 807.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 848.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 965.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 807.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 807.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 727.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 361.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 727.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 965.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1084.86
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1164.24
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 992.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 845.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 965.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 965.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1096.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 861.27
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1124.55
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 727.65
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1124.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1124.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 848.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 965.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 866.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 848.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 965.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 734.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1323
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 734.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1096.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1010.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1124.55
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 859.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1070.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1010.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1124.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 848.04
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 734.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 866.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 848.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 807.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1124.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1084.86
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1010.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 807.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 807.03
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 866.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 848.04
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 734.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 866.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 861.27
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 845.4
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1124.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 992.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1084.86
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1124.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1096.77
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 807.03
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1124.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 866.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1160.27
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1124.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 848.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 861.27
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1124.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 807.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 727.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1084.86
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1160.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 992.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 807.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1084.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 727.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 848.04
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1124.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 807.03
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 848.04
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 873.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1084.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 866.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 866.57
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1323,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 845.4
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 289.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 807.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 861.27
            }
          ]
        }
      ]
    },
    {
      "description": "NAIL 11 X 270MM TI CANN TIB EX STERL PROX BEND",
      "code_information": [
        {
          "code": "SUP-04.034.534S",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3353.07,
          "discounted_cash": 2179.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2561.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2196.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2045.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2142.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2850.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2749.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2712.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2182.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2940.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2045.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1844.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2749.52
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2179.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2850.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2149.32
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2950.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2850.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1860.95
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2850.11
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2196.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1844.19
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2142.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2447.74
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2561.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2045.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2149.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2850.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2045.37
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2447.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2196.26
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 734.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2149.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2561.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1844.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2149.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2149.32
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2149.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2045.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2045.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2045.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1844.19
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2850.11
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2850.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2045.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2850.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2447.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1844.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2749.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2749.52
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2850.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2045.37
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2514.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2779.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2514.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2149.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2196.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2561.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2850.11
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1860.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2182.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2182.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2196.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2045.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2142.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1844.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2749.52
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2182.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2149.32
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2850.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2045.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2850.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2447.74
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 915.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2447.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2779.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2749.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2561.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2514.8
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2213.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2182.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2149.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2196.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2749.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2149.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3353.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2749.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2045.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2149.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2142.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2712.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2561.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1844.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1860.95
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2196.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2940.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2045.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2447.74
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2149.32
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3353.07,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1860.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2196.26
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2850.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2779.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2850.11
            }
          ]
        }
      ]
    },
    {
      "description": "BUTTON 2.5MM CERCLAGE HEX TI T15 STERL",
      "code_information": [
        {
          "code": "SUP-04.221.002S",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 403.5,
          "discounted_cash": 262.27,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 258.64
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 257.84
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.98
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 334.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 302.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 294.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 330.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 246.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 257.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 262.68
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 264.29
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 330.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 221.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 246.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 223.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 330.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 326.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 264.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 257.84
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 302.63
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.98
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 308.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 264.29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 246.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 294.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 246.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 258.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 258.64
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 258.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 246.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 246.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 246.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 330.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 257.84
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 262.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 258.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 223.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 262.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 262.68
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 223.94
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 264.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 246.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 353.87
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 308.27
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 221.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 246.14
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 330.87
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 258.64
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 264.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 246.14
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 221.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 294.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 403.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 330.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 246.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 258.64
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 246.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 308.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 258.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 264.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 258.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 308.27
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 266.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 353.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 221.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 221.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 330.87
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 110.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 258.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 221.93
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.98
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 223.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 330.87
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 355.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 246.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 308.27
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 264.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 294.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 334.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 258.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 258.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 221.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 334.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 294.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 262.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 264.29
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 302.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 262.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 308.27
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 294.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 326.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 342.98
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 403.5,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "BAG 8 X 125ML TISSUE RETRIEVAL SYSTEM ANCHOR",
      "code_information": [
        {
          "code": "SUP-TRSROBO8",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 238.2,
          "discounted_cash": 154.83,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 149.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 195.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 181.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 131.01
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 154.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 149.59
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 149.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 154.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 178.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 173.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 150.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 149.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 149.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 195.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 132.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 155.07
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 209.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 132.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 155.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 150.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 149.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 149.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 154.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 178.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.47
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 238.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 132.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 238.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 195.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 192.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 155.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 195.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 149.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 150.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 149.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 195.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 149.59
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 150.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 150.54
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 131.01
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 178.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 154.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 181.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 150.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 149.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 131.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 195.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 173.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 132.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 197.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 155.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 131.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 131.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 181.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 208.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 131.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 181.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 208.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 173.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 154.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 173.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 173.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 197.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 150.54
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 152.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 173.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 197.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 181.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 149.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 195.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 192.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 195.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 150.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 181.98
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 157.21
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 202.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 149.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 155.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 131.01
            }
          ]
        }
      ]
    },
    {
      "description": "DRESSING OPEN ABDOMEN ABTHERA ADVANCED",
      "code_information": [
        {
          "code": "SUP-ABT1055",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1863.21,
          "discounted_cash": 1211.09,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1423.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1177.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1177.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1583.73
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1397.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1544.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1196.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1527.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1196.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1583.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1209.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1634.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1034.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1034.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1034.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1423.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1583.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1024.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1177.55
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1583.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1544.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1177.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1196.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1397.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1360.14
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 508.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1212.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1196.18
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1229.72
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1583.73
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1583.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1196.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1583.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1196.18
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1583.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1527.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1177.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1177.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1527.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1423.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1527.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1527.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1583.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1209.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1360.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1863.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1196.18
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1583.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1212.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1360.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1024.77
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1863.21,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1583.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1209.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1196.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1397.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1212.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1583.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1360.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1212.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1423.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1423.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1360.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1034.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1527.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1024.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1423.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1527.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1527.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1634.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1212.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1507.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1196.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1544.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1177.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1196.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1177.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1024.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1360.14
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1211.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1196.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1170.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1024.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1507.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1209.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1024.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1196.18
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1639.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1024.77
            }
          ]
        }
      ]
    },
    {
      "description": "FEMORAL SZ10 LT STD CR CMT CCR PERSONA",
      "code_information": [
        {
          "code": "SUP-42-5026-068-01",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4762.8,
          "discounted_cash": 3095.82,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3638.78
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4048.38
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 857.3
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2619.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3476.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3476.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3905.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2905.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3043.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3052.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3052.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3948.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3905.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4048.38
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4048.38
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 857.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3119.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3119.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2619.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2643.35
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3638.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1043.05
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2905.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4048.38
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4048.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4176.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4048.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3052.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4762.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4048.38
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3100.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2619.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3476.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2905.31
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3476.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2643.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3905.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2905.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2905.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3572.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4048.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3905.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2905.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3853.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4176.98
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3119.63
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3905.5
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3095.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3638.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3476.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3948.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3905.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3100.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3100.58
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4048.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3119.63
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4191.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3052.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4048.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3572.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3043.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2643.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3905.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2619.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3119.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3052.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2619.54
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4048.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3853.11
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3143.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2905.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3043.43
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3119.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3052.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3100.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3119.63
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3043.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3052.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3638.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2905.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2643.35
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1300.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4048.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3119.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3476.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3948.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3638.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2905.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2905.31
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2905.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3100.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3052.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3638.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3905.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2619.54
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3052.95
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4048.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3052.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3052.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3572.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4048.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2905.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3052.95
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4762.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2619.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2905.31
            }
          ]
        }
      ]
    },
    {
      "description": "BODY 70MM SZA STD OFFSET CONE ARCOS",
      "code_information": [
        {
          "code": "SUP-11-301321",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 17666.91,
          "discounted_cash": 11483.49,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11324.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11571.83
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9805.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 17666.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14486.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 11289.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11324.49
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15016.87
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15016.87
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13250.18
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11324.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13497.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10776.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11501.16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 15546.88
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15016.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11324.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15016.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12896.84
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10776.82
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15016.87
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15016.87
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 11483.49
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15016.87
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11571.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9716.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15016.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11571.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10776.82
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12896.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9716.8
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 11289.16
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12896.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14486.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11571.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11324.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11324.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11324.49
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 3180.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14486.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10776.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13497.52
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15493.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12896.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14645.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11324.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11324.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10776.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 11289.16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11571.83
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 11660.16
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11571.83
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9716.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12896.84
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13250.18
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 3180.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9716.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9805.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11501.16
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4823.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12896.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14292.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15016.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9805.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15016.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9716.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13497.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11571.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11324.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14486.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 11289.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10776.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10776.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11501.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11324.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11324.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15016.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10776.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10776.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10776.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14486.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14486.87
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9716.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13250.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13497.52
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 3869.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14645.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14486.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10776.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10776.82
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14292.53
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17666.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13497.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11501.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11501.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11571.83
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15016.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9716.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15016.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9805.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10776.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13497.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15493.88
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15016.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14645.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14486.87
            }
          ]
        }
      ]
    },
    {
      "description": "BONE 5CC MED CELLULAR MATRIX VIVIGEN FORMABLE",
      "code_information": [
        {
          "code": "SUP-BL-1600-002",
          "type": "CDM"
        },
        {
          "code": "C1762",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5700,
          "discounted_cash": 3705,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3653.7
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3477
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3477
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4354.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3477
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3710.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3710.7
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4845
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3653.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3653.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4161
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3163.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1026
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3733.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4845
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3163.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3642.3
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3710.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4161
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4674
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3477
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3642.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3653.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4354.8
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1248.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4674
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4845
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4161
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4354.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4845
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4845
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3477
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3135
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4161
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3653.7
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4845
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3653.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3653.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4354.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4725.3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3705
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3477
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4275
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3135
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3163.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3477
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3653.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3477
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3733.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3733.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3733.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3733.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4845
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4845
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3762
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1026
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4611.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4674
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3477
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3642.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3135
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3733.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4275
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3163.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3477
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3710.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3653.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3135
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3135
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4161
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3477
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3477
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4611.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3135
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4845
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3653.7
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4674
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3642.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4998.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5016
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4845
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4998.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3653.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3653.7
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4674
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4674
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3710.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3733.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4845
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4275
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3733.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4845
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4725.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4674
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4674
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1556.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4354.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5700
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4725.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3477
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4161
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4354.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4845
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3135
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5700,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4845
            }
          ]
        }
      ]
    },
    {
      "description": "STEM SZ10 APEX UNIVERS REVERS",
      "code_information": [
        {
          "code": "SUP-AR950110S",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8059.5,
          "discounted_cash": 5238.67,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5166.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5166.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6044.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5278.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5278.97
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1450.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4432.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6157.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6681.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4916.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4916.3
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6850.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4432.73
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6044.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6850.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6157.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5166.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4473.02
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6520.14
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7068.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6608.79
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4473.02
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5278.97
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4432.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5883.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5246.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5278.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4432.73
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6850.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5278.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5883.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5883.44
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6608.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5246.73
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6850.58
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6850.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5150.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5166.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5883.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4473.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5278.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5166.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6608.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4916.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5150.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6520.14
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2200.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5150.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5166.14
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5319.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5166.14
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5883.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4916.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4432.73
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6850.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6157.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4473.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6681.33
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6850.58
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5166.14
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6850.58
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6850.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6850.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4916.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4916.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4916.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5246.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5246.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5150.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4916.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1450.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4432.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6157.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5278.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6157.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5883.44
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1765.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4432.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4916.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6608.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6608.79
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6044.63
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7092.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8059.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5166.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6157.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5166.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6850.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5278.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6608.79
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6850.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4916.3
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6608.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4916.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4916.3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5238.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5166.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5166.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8059.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6850.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6681.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4916.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6850.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6608.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5246.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7068.18
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 25MM MOD CENTRAL UNIVERS REVERS",
      "code_information": [
        {
          "code": "SUP-AR-9561-25S",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2565,
          "discounted_cash": 1667.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1644.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1680.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1410.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1872.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1564.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1564.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1644.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1669.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1644.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1644.17
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1923.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1410.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1959.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2103.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1564.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2180.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1410.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2180.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1423.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1669.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2103.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1564.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2075.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1680.08
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1692.9
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2180.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2249.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1669.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2103.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1564.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1680.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1639.04
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1680.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2180.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1959.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1959.66
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2180.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1410.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2180.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1644.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1872.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2565
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1680.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1680.08
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2180.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2103.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1564.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1680.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1872.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1564.65
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2075.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2249.51
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2180.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1644.17
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2180.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2103.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1564.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1564.65
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2180.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1872.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2103.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1639.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1872.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1639.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1959.66
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 561.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1959.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1644.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1680.08
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2180.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2180.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1423.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1872.45
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1423.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1644.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1644.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1959.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2180.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2126.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2126.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1564.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1564.65
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1410.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2126.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1639.04
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2257.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1923.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1644.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1423.58
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1923.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2103.3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1667.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1669.82
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 700.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2180.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2103.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1669.82
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1644.17
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2565,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1564.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1564.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1410.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1410.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1644.17
            }
          ]
        }
      ]
    },
    {
      "description": "DEVICE 2 X 2CM WICK BIORESORABLE MICROFIBER ROTIUM",
      "code_information": [
        {
          "code": "SUP-FG-0007S",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1800,
          "discounted_cash": 1170,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1153.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1153.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1476
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1150.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1153.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1492.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1098
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1153.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1530
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 990
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1530
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1530
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 999
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1179
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1179
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1530
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1492.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1476
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1375.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1800
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1314
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1492.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1098
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1153.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1170
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1530
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1375.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1314
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1098
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1171.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1171.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1476
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1171.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1179
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1530
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1530
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1350
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 491.4
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1530
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 999
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1476
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1098
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1098
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 990
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 990
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1098
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1530
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 394.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1153.8
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 990
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1150.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1314
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 990
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1179
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1530
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1153.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1350
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1150.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1098
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1530
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1153.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1153.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1578.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1530
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1314
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 999
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1314
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1476
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1150.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1456.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1375.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1476
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1098
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1098
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1153.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1153.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1179
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1476
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 990
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1098
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1456.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1171.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1171.8
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1584
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1188
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1578.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1375.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1098
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1530
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1153.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1314
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1476
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1098
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1179
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 990
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1098
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 999
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1179
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1179
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1375.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1375.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1350
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1530
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 2.8 X 16MM LOCK SOLID F/ PLATING SYSTEM OMNI",
      "code_information": [
        {
          "code": "SUP-144-28116",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 660,
          "discounted_cash": 429,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 423.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 432.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 481.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 366.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 402.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 561
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 366.3
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 561
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 495
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 363
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 402.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 429.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 432.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 423.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 432.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 402.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 561
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 432.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 423.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 561
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 481.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 429.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 547.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 547.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 363
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 547.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 541.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 402.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 423.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 561
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 561
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 432.3
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 541.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 541.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 402.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 561
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 660
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 660,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 481.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 578.82
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 423.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 504.24
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 660,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 541.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 541.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 402.6
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 435.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 432.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 481.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 402.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 533.94
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 423.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 504.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 423.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 541.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 429.66
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 660,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 363
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 481.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 421.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 504.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 504.24
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 561
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 363
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 495
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 432.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 481.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 504.24
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 660,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 421.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 402.6
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 180.18
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 429
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 363
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 423.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 402.6
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 660,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 402.6
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 402.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 402.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 541.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 421.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 504.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 561
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 363
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 363
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 561
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 578.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 423.06
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 561
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 421.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 366.3
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 580.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 495
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 561
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 423.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 423.06
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 561
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 541.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 402.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 533.94
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 660,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 423.06
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 660,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 366.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 561
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 429.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 432.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 429.66
            }
          ]
        }
      ]
    },
    {
      "description": "FORCEPS BIPOLAR MARYLAND DAVINCI S REPOS/10",
      "code_information": [
        {
          "code": "SUP-420172",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 850.5,
          "discounted_cash": 552.82,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 649.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 649.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 537.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 620.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 467.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 467.78
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 722.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 697.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 649.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 688.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 472.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 534.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 534.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 620.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 553.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 553.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 697.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 534.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 472.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 850.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 537.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 722.93
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 722.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 705.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 697.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 620.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 705.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 534.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 553.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 688.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 537.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 467.78
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 850.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 748.44
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 722.93
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 637.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 637.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 472.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 637.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 534.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 472.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 697.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 534.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 553.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 620.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 534.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 551.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 745.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 534.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 649.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 537.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 697.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 534.11
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 722.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 722.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 722.93
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 232.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 537.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 537.52
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 552.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 537.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 705.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 551.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 534.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 551.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 745.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.02
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 722.93
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 561.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 467.78
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 722.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 537.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 620.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 649.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 697.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.02
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 722.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 467.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 534.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 534.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 620.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 534.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 553.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 467.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 722.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 467.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 649.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 697.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 697.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 722.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 551.97
            }
          ]
        }
      ]
    },
    {
      "description": "VALVE CHEST DRAIN COOK",
      "code_information": [
        {
          "code": "SUP-C-CDV-1",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 227.4,
          "discounted_cash": 147.81,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 173.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 142.81
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 193.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 188.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 173.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 142.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 147.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 166
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 183.97
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 193.29
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 150.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 188.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 143.72
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 147.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 186.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 186.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 148.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 148.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 193.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 170.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 193.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 166
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 193.29
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 193.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 173.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 173.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 166
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 193.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 126.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 143.72
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 193.29
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 193.29
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 227.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 186.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 173.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 126.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 142.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.07
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 170.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 193.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 147.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 183.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 147.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 148.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 193.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 173.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 143.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 186.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 147.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 142.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 186.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 148.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 186.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 186.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 186.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 142.81
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 62.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 143.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 126.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 188.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 142.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 143.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 193.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 199.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 143.72
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 200.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 142.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 142.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 142.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 142.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 166
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 227.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 126.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 199.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 143.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 170.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 166
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 166
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 142.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 148.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 143.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 142.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 142.81
            }
          ]
        }
      ]
    },
    {
      "description": "SOLUTION 1000ML BAG WOUND LAVAGE BACTISURE MIN ORDER 6EA",
      "code_information": [
        {
          "code": "SUP-00888700200",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2250,
          "discounted_cash": 1462.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1719
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1444.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1845
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1413
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1237.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1912.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1444.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1444.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1237.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1422
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1719
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1444.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1248.75
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1980
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1460.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1460.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1912.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1444.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1865.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1845
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1642.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1845
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1444.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1422
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1460.25
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1485
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1642.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1865.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1845
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1845
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2250
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1912.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1719
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1413
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1464.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1973.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1444.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1845
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1413
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1248.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1464.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1422
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1444.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1237.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1444.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1912.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1820.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1462.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1422
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1422
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1912.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1820.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2250,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1719
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1865.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1912.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1422
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1912.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1912.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1687.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1464.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1687.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1248.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1237.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1719
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1719
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1845
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1413
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1413
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1687.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1912.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1237.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1912.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1642.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1845
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1413
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1413
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1413
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1642.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1460.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1464.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1422
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1444.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1912.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 614.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1973.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1248.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1413
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1642.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1444.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1912.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1413
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1413
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1237.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1444.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1237.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1413
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1413
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1422
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1464.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1642.5
            }
          ]
        }
      ]
    },
    {
      "description": "GUIDEWIRE FOR 3.5/4MM CANN SCREW SET",
      "code_information": [
        {
          "code": "SUP-900.721",
          "type": "CDM"
        },
        {
          "code": "C1769",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 63.75,
          "discounted_cash": 41.44,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.06
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 63.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.93
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.93
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.06
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.93
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 42.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.71
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 41.44
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.38
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.93
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.93
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.75,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "ANCHOR 4.75 X 19.1MM FIBERTAPE VENTED BIOCOMP SWIVELOCK C",
      "code_information": [
        {
          "code": "SUP-AR-2324BCCT",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1480.5,
          "discounted_cash": 962.32,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 949
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 949
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1080.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 814.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 963.81
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1258.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 946.04
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1258.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1131.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1080.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 903.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 903.11
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1258.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1214.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 814.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1214.01
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1258.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1131.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 946.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 903.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 949
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 949
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1110.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 949
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 324.23
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1302.84
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 814.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1080.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 903.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 903.11
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1258.43
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1258.43
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1258.43
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 962.33
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1258.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1258.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1080.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1214.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 903.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 963.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 969.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1480.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1214.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 969.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1298.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1131.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 814.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1080.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 949
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1110.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1131.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 946.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 969.73
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 949
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 814.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1080.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1214.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 903.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 903.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 903.11
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 404.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 969.73
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 977.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 949
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1258.43
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1258.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1214.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 963.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 969.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1214.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 949
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1258.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 814.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 821.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1197.72
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1298.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1258.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1131.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 949
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 903.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1197.72
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 969.73
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 969.73
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 903.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 969.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 814.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1227.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 963.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 963.81
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1110.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 821.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 903.11
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1227.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 821.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1214.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 946.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 903.11
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1480.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1258.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 949
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 949
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1131.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 821.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1227.33
            }
          ]
        }
      ]
    },
    {
      "description": "HEAD 28MM/4 FEM V40 BIOLOX DELTA",
      "code_information": [
        {
          "code": "SUP-6570-0-228",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1926,
          "discounted_cash": 1251.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1234.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1471.46
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1174.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1068.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1068.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1637.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1174.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1174.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1253.83
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1471.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1068.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1579.32
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 525.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1234.57
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1637.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1926
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1174.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1579.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1579.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1261.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1059.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1261.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1174.86
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1059.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1558.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1261.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1261.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1234.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1596.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1174.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1444.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1637.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1059.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1471.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1444.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1689.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1234.57
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1637.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1637.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1444.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1558.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1261.53
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1174.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1253.83
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1637.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1689.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1471.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1637.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1637.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1251.9
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1174.86
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1234.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1234.57
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1637.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1637.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1068.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1579.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1174.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1261.53
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 421.79
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1694.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1234.57
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1271.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1405.98
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1261.53
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1637.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1230.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1471.46
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1059.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1405.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1174.86
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1234.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1234.57
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1174.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1234.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1596.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1059.3
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1579.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1579.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1253.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1253.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1253.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1059.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1405.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1234.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1234.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1230.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1174.86
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1174.86
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1637.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1405.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1596.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1405.98
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1261.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1059.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1471.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1230.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1405.98
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1637.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1637.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1579.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1579.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1230.71
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1926,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "BALL 28 1.5 GR ARTICUL/EZE",
      "code_information": [
        {
          "code": "SUP-136511000",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1350,
          "discounted_cash": 877.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 865.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 884.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 884.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 884.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 884.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 884.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1092.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 884.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 823.5
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1147.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1183.95
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1188
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 878.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 742.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 742.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1031.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 865.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1107
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 823.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 878.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 878.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1147.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 742.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1031.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 749.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1107
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 865.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 865.35
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1147.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1012.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 862.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 985.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 823.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1092.15
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1147.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1107
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1107
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 823.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1147.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1031.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 985.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 865.35
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 742.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 862.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 823.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 823.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 823.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 823.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 865.35
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1183.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1350
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1012.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1147.5
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 891
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 985.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 749.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1107
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 823.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1147.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 749.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 823.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 862.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 823.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 865.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 985.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1031.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1031.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 884.25
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 368.55
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1147.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1147.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 865.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1119.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 884.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 865.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1107
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 877.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1147.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 985.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 742.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 742.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1119.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 823.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 862.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 878.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1119.15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1147.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 865.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1147.5
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 295.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1031.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1147.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 865.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 985.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 749.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1107
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1107
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 742.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1012.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 865.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 823.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 878.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1147.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1350,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "INSERT 10MM SZE 4 INFINITY EVERLAST",
      "code_information": [
        {
          "code": "SUP-33684410",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8211,
          "discounted_cash": 5337.15,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5263.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6273.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6979.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5378.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5378.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6733.02
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6806.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5008.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6733.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5345.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4516.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5263.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5008.71
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6979.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6158.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4557.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6642.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4516.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5994.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5008.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5378.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4516.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5263.25
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7225.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5008.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5263.25
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4516.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5263.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6273.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5008.71
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6979.35
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1798.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5263.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5994.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6806.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5246.83
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5263.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5008.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5263.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6979.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6733.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4516.05
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7201.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6733.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5263.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6273.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6158.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4557.11
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6979.35
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6158.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5994.03
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5008.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5994.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6733.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6733.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5345.36
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2241.6
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6979.35
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6979.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6273.2
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6979.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6733.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5263.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6979.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6806.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6733.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5008.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5008.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5263.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4557.11
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1477.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5246.83
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6979.35
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4516.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4516.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5008.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5994.03
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5345.36
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5337.15
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5419.26
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6979.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5246.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5378.21
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5008.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5246.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6642.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5345.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8211
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5008.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5378.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5378.21
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6979.35
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1477.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5263.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5994.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4557.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5008.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5345.36
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7201.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5378.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5378.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6273.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6979.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6979.35
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8211,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6273.2
            }
          ]
        }
      ]
    },
    {
      "description": "WIRE K 1.1 X 102MM PHALINX",
      "code_information": [
        {
          "code": "SUP-45302002",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 84,
          "discounted_cash": 54.6,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 53.84
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 73.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 55.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.32
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 51.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 54.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 53.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 53.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 51.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 51.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 73.67
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 64.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.4
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 64.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 67.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 73.67
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 64.18
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 55.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 51.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 67.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 53.84
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 51.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 54.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.4
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 84,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 53.68
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 54.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 55.02
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 64.18
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 69.64
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 22.93
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 46.62
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 55.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 46.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 46.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 69.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.88
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 54.68
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 84,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 46.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 51.24
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 51.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 51.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 51.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 51.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 84,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 55.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 64.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 53.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 53.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 53.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 51.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 53.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 64.18
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 84,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 53.84
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 69.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 55.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 55.02
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 84,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 53.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 53.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 53.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 53.84
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 53.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 55.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 51.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 51.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 54.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 53.84
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 84,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 55.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.88
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 54.68
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.4
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 3 X 22MM HV PORSTEP",
      "code_information": [
        {
          "code": "SUP-HVS03022",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1251,
          "discounted_cash": 813.15,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 801.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1025.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 694.31
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 688.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1025.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1012.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1012.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 814.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 955.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 801.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 955.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1097.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 813.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1037.08
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 688.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 801.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 801.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 763.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1025.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 819.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 801.89
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 913.23
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 938.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 819.41
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1100.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1025.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1063.35
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1063.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 688.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 801.89
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 938.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 801.89
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1063.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1025.82
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 688.05
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 273.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1025.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1025.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 763.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 763.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 814.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 814.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1063.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 955.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1063.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 938.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 763.11
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 341.52
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 819.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1251
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1037.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 799.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 819.41
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1063.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 819.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 955.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 913.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 801.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 913.23
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1063.35
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1037.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 763.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 801.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 801.89
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 825.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 913.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 763.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 955.76
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 913.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 763.11
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 819.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 801.89
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1097.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 763.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 763.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 694.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 763.11
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1063.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 955.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 694.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 799.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 688.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 694.31
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1063.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1063.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 688.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1063.35
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1063.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 763.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 799.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 819.41
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1063.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 688.05
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1063.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 913.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 763.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 799.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 814.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 801.89
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1251,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 819.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1025.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 814.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 763.11
            }
          ]
        }
      ]
    },
    {
      "description": "INSERT SZ3/4 0 X 39MM HUM SYMMETRIC REV PERFORM",
      "code_information": [
        {
          "code": "SUP-DWP2390",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4560,
          "discounted_cash": 2964,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2922.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2922.96
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 998.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2986.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3876
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2781.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2968.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2922.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3483.84
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3876
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2781.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2968.56
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3876
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4012.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3739.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2781.6
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2986.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2986.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2922.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3739.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2913.84
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3876
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2508
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3739.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3483.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3876
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2922.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3999.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2968.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3689.04
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2508
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3420
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2922.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3483.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3739.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2964
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3328.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3328.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2922.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3876
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2508
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3739.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2781.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3999.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2922.96
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3780.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2986.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3876
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3780.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2781.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2922.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3328.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2781.6
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3876
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3420
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2508
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2781.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1244.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2922.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2530.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2913.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3876
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2508
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2781.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2781.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2781.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2968.56
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3009.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2508
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2781.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2968.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3876
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2986.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2986.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2508
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3483.84
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3328.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3483.84
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2986.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2986.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2922.96
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3876
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2530.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3780.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3739.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2781.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3739.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3876
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2530.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4560
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2922.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2913.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3689.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3328.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3328.8
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3876
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3739.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3420
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2781.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2530.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4560,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3876
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3483.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2913.84
            }
          ]
        }
      ]
    },
    {
      "description": "KIT OSTEOTOME 3 BLADES F/ FEM STEM REMOVAL EXODUS",
      "code_information": [
        {
          "code": "SUP-00-510-400-00",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5805,
          "discounted_cash": 3773.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4435.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4353.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3668.76
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4934.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4812.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3192.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4237.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3779.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3192.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4760.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4353.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4934.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4237.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3645.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4934.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3726.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4237.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5805
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3645.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3645.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3726.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4237.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4435.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3767.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3767.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3192.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4696.25
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1584.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3668.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3767.45
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4934.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4934.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3668.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3726.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3726.81
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5805,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4812.35
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4934.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3668.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3668.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3645.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4760.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3726.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4934.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4353.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3221.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4760.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3645.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4760.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3779.06
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5108.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4435.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3645.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3645.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3645.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3767.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3645.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3779.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3726.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3192.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3221.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3221.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4760.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3779.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4934.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3192.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3192.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3726.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4934.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4237.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5090.99
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3773.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5090.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3668.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4812.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4760.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3645.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3645.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3192.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4435.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3726.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4435.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4237.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3668.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3645.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3645.54
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4934.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3726.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3779.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3221.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4696.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3668.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3726.81
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4934.25
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3831.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4934.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3726.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4435.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4760.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4760.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3726.81
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 5 X 55MM CORT T20 DRIVE LOCK ST TI LP AXSOS",
      "code_information": [
        {
          "code": "SUP-661155",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 691.2,
          "discounted_cash": 449.28,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 443.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 452.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 587.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 566.78
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 449.97
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 504.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 421.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 559.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 443.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 443.06
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 566.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 449.97
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 518.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 504.58
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 587.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 573
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 421.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 441.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 441.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 443.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 452.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 606.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 566.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 566.78
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 504.58
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 421.63
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 587.52
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 456.19
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 443.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 528.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 443.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 504.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 380.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 383.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 441.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 559.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 587.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 449.97
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 380.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 380.16
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 587.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 421.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 518.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 528.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 566.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 452.74
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 608.26
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 587.52
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 518.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 452.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 452.74
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 441.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 421.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 691.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 421.63
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 587.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 528.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 528.08
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 587.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 443.06
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 504.58
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 188.7
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 566.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 587.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 380.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 573
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 421.63
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 587.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 606.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 380.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 380.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 443.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 383.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 383.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 573
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 421.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 449.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 452.74
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 449.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 443.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 443.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 452.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 587.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 449.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 566.78
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 380.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 528.08
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 587.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 504.58
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 587.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 443.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 383.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 566.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 443.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 421.63
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 528.08
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 691.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 421.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 452.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 587.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 421.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 421.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 421.63
            }
          ]
        }
      ]
    },
    {
      "description": "PLATE 6HL 166MM LT FEM DIST LAT LOCK TI AXSOS",
      "code_information": [
        {
          "code": "SUP-627606",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8140.8,
          "discounted_cash": 5291.52,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5218.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5218.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5332.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4965.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4477.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5332.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6675.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6675.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6219.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4518.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6675.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4965.89
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6919.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5942.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6219.57
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2222.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5218.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6919.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6675.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4965.89
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5201.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5299.66
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1465.34
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5218.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5218.25
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6919.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6675.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5201.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5299.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4965.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4477.44
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5201.97
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6105.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5942.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6105.6
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6919.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4965.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4477.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4965.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4965.89
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6919.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5218.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6219.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6748.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6585.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5332.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5942.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5218.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7163.9
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4477.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5942.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6919.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5218.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5332.22
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5299.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6219.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5218.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6219.57
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5372.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4965.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7139.48
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5291.52
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6675.46
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4477.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4477.44
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6919.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6919.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5218.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1465.34
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4477.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6748.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5201.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6748.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4965.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5299.66
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6919.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4965.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5299.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5942.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5332.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5218.25
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1782.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4518.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6919.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5332.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6219.57
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8140.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6585.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4965.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5332.22
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6919.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5942.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5218.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4965.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4965.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6675.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5332.22
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6919.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6919.68
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6105.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6675.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6919.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4518.14
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8140.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7139.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4518.14
            }
          ]
        }
      ]
    },
    {
      "description": "PLATE 9HL 56MM SHT DIST RAD VOLAR SMARTLOCK NAR RT VARIAX",
      "code_information": [
        {
          "code": "SUP-5425384",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2962.05,
          "discounted_cash": 1925.33,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2263.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2517.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2221.54
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2517.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1940.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2396.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1940.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1643.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1892.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1806.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1629.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2597.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1629.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1629.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2162.3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2517.74
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1643.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1806.85
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2517.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2428.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1806.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1806.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1806.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1806.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2263.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1898.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1928.29
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2517.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2162.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2263.01
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2597.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1940.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2263.01
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 808.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1940.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1898.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1629.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2455.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2428.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1892.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1629.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2428.88
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 648.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1643.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1898.67
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2162.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1928.29
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1898.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1898.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1629.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2396.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1892.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2517.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2428.88
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2517.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2221.54
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1806.85
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1925.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1940.14
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2517.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1643.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1806.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1898.67
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1954.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2428.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2428.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1892.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1806.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2517.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1898.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2263.01
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2517.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1928.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2162.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2606.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1898.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2517.74
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1806.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1928.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1940.14
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2517.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2517.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1898.67
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1898.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2455.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2428.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1806.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1928.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1898.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1898.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1940.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1806.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2263.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2455.54
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1629.13
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2221.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2162.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2428.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1940.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2962.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2517.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1806.85
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2962.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2162.3
            }
          ]
        }
      ]
    },
    {
      "description": "RING 240MM ALUMINUM FULL HOFFMANN LRF SYS",
      "code_information": [
        {
          "code": "SUP-4933-2-240",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3906,
          "discounted_cash": 2538.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2507.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2468.59
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3320.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2452.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2542.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2468.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2452.97
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2929.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3906
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3202.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2167.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3202.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2542.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2468.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2984.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2507.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2507.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2468.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3202.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2507.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3320.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2167.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2148.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2851.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3320.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2452.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2984.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2984.18
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3320.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2538.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2468.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2452.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2507.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2851.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2851.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3320.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2452.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2468.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2507.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3238.07
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 3437.28
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3320.1
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3906,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2148.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3159.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3238.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3202.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2452.97
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3320.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2507.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2148.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3425.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2534.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2984.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2452.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2534.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2468.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2468.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2148.3
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1066.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2984.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2851.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3238.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2542.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3202.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2929.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3320.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2507.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2452.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3159.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2542.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2984.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2148.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2167.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2452.97
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2577.96
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3320.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2452.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2148.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2534.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3425.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3320.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2167.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2507.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2534.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2452.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2507.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2507.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3320.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3202.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3202.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2851.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2929.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2452.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2148.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3320.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2851.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2507.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2452.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3202.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2542.81
            }
          ]
        }
      ]
    },
    {
      "description": "SUTURE 1.2MM NONABSORBABLE VIOLET XBRAID TT",
      "code_information": [
        {
          "code": "SUP-3910-900-017",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 433.2,
          "discounted_cash": 281.58,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 330.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 355.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 355.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 282.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 330.96
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 281.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 330.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 240.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 350.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 324.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 240.43
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 433.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 240.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 282.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 433.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 359.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 355.22
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 285.91
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 118.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 316.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 355.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 238.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 330.96
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.22
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 316.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 330.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 359.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 355.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 350.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 238.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 324.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 281.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 281.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 281.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 316.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.78
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.22
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.22
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 238.26
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.22
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 381.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 238.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 355.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 282.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 355.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 379.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 379.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 355.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 330.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 316.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 238.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 359.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 281.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 282.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 282.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 316.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 240.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 316.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 238.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 238.26
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 324.9
            }
          ]
        }
      ]
    },
    {
      "description": "KIT ARTHROSCOPY PORTAL ENTRY",
      "code_information": [
        {
          "code": "SUP-CAT00241",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1038.57,
          "discounted_cash": 675.07,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 666.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 666.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 666.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 576.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 676.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 840.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 882.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 576.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 666.76
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 685.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 674.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 676.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 656.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 882.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 666.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 656.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 851.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 674.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 793.47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 882.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 571.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 676.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 666.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 882.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 758.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 882.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 910.83
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 882.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 666.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 860.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1038.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 851.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 793.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 793.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 758.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 656.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 666.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 571.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 674.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 652.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 576.41
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 882.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 676.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 676.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 571.21
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 675.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 851.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 851.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 851.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 656.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 666.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 758.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 758.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 571.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 860.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 656.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 851.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 652.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 652.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 652.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 793.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 652.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 652.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 652.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 656.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 656.38
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 882.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 910.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 571.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 656.38
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 913.94
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 882.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 576.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 652.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 840.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1038.57,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 860.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 666.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 652.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 778.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 758.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 571.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 851.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 652.22
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 283.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 666.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 793.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 778.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 758.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 851.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 652.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 652.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 666.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 882.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 674.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 778.93
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 882.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 793.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 882.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 571.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 652.22
            }
          ]
        }
      ]
    },
    {
      "description": "SUTURE 1 30CM STRATAFIX SPIRAL PDS PLUS SXPP2B201 OS-6",
      "code_information": [
        {
          "code": "SUP-SXPP2B201",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 63.99,
          "discounted_cash": 41.59,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.47
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.47
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 56.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.44
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.19
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 41.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.66
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 42.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 63.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.44
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.39
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 56.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.19
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.89
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.47
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.39
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.19
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.99,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 40.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 56.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.19
            }
          ]
        }
      ]
    },
    {
      "description": "COMPONENT FEM SZ9 STD RT CR CEMENTED PERSONA",
      "code_information": [
        {
          "code": "SUP-42-5046-066-01",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 17595.9,
          "discounted_cash": 11437.33,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13443.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13443.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 11243.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11525.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15431.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14956.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 11243.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10733.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14956.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10733.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13443.27
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9765.72
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 11613.29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14956.52
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15431.6
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 3853.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14956.52
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14956.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9677.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14956.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13443.27
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4803.68
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9677.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14956.52
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14956.52
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11278.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13443.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13443.27
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14956.52
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9677.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13196.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14587
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14428.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11278.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11278.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11454.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11525.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9677.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9677.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11278.97
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12845.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12845.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11525.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12845.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11278.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11278.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12845.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13196.93
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 3167.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14428.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14428.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10733.5
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9677.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9765.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10733.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11278.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11278.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11278.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11278.97
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11525.31
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 15484.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14428.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10733.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11278.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9677.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 11243.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10733.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14956.52
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10733.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14428.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11454.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14956.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10733.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14956.52
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11525.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11525.31
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11454.93
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 17595.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9765.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11454.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14235.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11525.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14956.52
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 3167.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12845.01
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 11437.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 11243.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11454.93
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13196.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14428.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10733.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14235.08
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11278.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9765.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14428.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10733.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10733.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10733.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14587
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14587
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14956.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12845.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17595.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11525.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14428.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10733.5
            }
          ]
        }
      ]
    },
    {
      "description": "STEM 13 X 135MM EXTENSION 3MM OFFSET PERSONA",
      "code_information": [
        {
          "code": "SUP-42-5603-135-13",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6420.96,
          "discounted_cash": 4173.62,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4115.84
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4687.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4205.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3563.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5322.98
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3916.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3916.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5631.18
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4173.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4115.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4905.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5457.82
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4237.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4905.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4905.61
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4205.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4102.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5457.82
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4687.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3916.79
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1155.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4905.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5457.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4115.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4115.84
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4115.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3531.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6420.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5265.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5265.19
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4205.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4687.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3563.63
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1155.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5265.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3916.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4102.99
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4205.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5457.82
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4180.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5457.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3563.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5265.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3531.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4205.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4205.73
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3531.53
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5457.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5265.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4180.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4905.61
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5457.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3563.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5194.56
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5650.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4687.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3916.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4102.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4180.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5322.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5265.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3916.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3916.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4180.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3531.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4815.72
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5457.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4115.84
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5457.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3916.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5194.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4115.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4115.84
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5457.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4115.84
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5457.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4687.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4102.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3916.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4205.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3531.53
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5457.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4180.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4115.84
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5457.82
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4205.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4905.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3916.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5631.18
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4815.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5265.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3916.79
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1752.92
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5322.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3916.79
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4115.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3531.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3531.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4815.72
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6420.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4115.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4687.3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5457.82
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1406.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5265.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3916.79
            }
          ]
        }
      ]
    },
    {
      "description": "STEM 13 X 150MM FEM W/ SCREW OSS",
      "code_information": [
        {
          "code": "SUP-15-0367",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5806.26,
          "discounted_cash": 3774.07,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3721.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4238.57
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3774.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3803.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4935.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3222.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4813.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4761.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4761.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3710.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3721.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4435.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3541.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3803.1
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3541.82
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4761.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3541.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3779.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3779.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3803.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3193.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3721.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4935.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4354.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5109.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4935.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4935.32
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3222.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4761.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3721.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3721.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3721.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3710.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3779.88
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4354.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4813.39
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1271.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4935.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4935.32
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1045.13
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4935.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4435.98
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3541.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3541.82
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3803.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3721.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3721.81
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3193.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3193.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4761.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3710.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4697.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4435.98
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3803.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3803.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4697.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4238.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3541.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5092.09
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4935.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3193.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5806.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3222.47
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4935.32
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1585.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3721.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3541.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3541.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3541.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3779.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4435.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4813.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3541.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3222.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4761.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3541.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3193.44
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4354.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4238.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4435.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3803.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3803.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5092.09
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4935.32
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4935.32
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3832.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4761.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4935.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3193.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4435.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3721.81
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4238.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3541.82
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3541.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3710.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3721.81
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4238.57
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4935.32
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5806.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3779.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3721.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4935.32
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1045.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4761.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3193.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4238.57
            }
          ]
        }
      ]
    },
    {
      "description": "SEGMENT 4CM DIAPHYSIS TAPERED OSS",
      "code_information": [
        {
          "code": "SUP-15-1837",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 18220.95,
          "discounted_cash": 11843.62,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13920.81
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15487.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14740.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11861.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 11114.78
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 18220.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 11114.78
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11934.72
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15487.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 11114.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 3279.77
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 12025.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14941.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 11114.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11934.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14941.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11679.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11679.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11679.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13920.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15487.81
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4974.32
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11679.63
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15487.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10021.52
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11934.72
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 3279.77
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13665.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13665.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10021.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13920.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 11643.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 11114.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14740.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 11643.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11861.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14941.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 11114.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10021.52
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11934.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11934.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15487.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14941.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11861.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13920.81
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15487.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14941.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 11114.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11861.84
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15487.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11679.63
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10021.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11861.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11679.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13301.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11679.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10112.63
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11679.63
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13301.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 11114.78
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11679.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15487.81
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15487.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13301.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14941.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14941.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 11643.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13665.71
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11934.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15105.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 11114.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 11114.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11934.72
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 16034.44
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10112.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15105.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14941.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10112.63
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10021.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15487.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11679.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10021.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11934.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15979.77
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 3990.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 11114.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 11114.78
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13920.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15487.81
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15487.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15487.81
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15979.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13920.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13301.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10021.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15105.17
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 11843.62
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18220.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13301.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11679.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 11679.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 11643.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13301.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10112.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 11114.78
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15487.81
            }
          ]
        }
      ]
    },
    {
      "description": "GRAFT 2CC HUM CORTICAL FIBER STAGRAFT",
      "code_information": [
        {
          "code": "SUP-48-2002",
          "type": "CDM"
        },
        {
          "code": "C1762",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1764,
          "discounted_cash": 1146.6,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1347.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1499.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1130.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1130.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1499.4
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1076.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1127.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1347.7
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 386.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1148.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1148.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1287.72
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1146.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1446.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1127.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1148.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1148.36
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1076.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1127.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1446.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1446.48
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1499.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 979.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1076.04
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1499.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1287.72
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1499.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1287.72
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1323
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1130.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1130.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1076.04
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1427.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1130.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1499.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 970.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 979.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1446.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1076.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1076.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1155.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1155.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1155.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1462.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1764
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1076.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1155.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1347.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1323
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 970.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1446.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1076.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1076.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1323
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1287.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1547.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1347.7
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1164.24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1499.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1462.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1547.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1076.04
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1499.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1130.72
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1499.4
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1499.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1287.72
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1499.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1462.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1127.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1155.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 970.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1446.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1076.04
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1155.42
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 970.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 970.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1446.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1155.42
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1552.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1155.42
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 970.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 970.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1130.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1347.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1130.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1076.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1148.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1287.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1130.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1130.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1446.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1427.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 979.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1076.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1499.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1499.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1130.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1499.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1130.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1347.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 979.02
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1764,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 481.57
            }
          ]
        }
      ]
    },
    {
      "description": "RING 180MM FULL ALUMINUM MAXFRAME",
      "code_information": [
        {
          "code": "SUP-03.312.180",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3050.52,
          "discounted_cash": 1982.84,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2330.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1958.43
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2684.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3050.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2330.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2287.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1693.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2501.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1979.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1985.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2330.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2226.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2330.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2528.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1915.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1958.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1677.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2226.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2528.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1985.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2501.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1915.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2467.87
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1982.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2592.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1958.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2592.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1677.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1927.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1958.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2592.94
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2592.94
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2287.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1915.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1958.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1677.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1915.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1979.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1985.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1958.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2501.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2501.43
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2592.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2226.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2501.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2467.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1677.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2330.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1979.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2226.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1985.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1927.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2675.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1927.93
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3050.52,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1915.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1985.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2330.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1979.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1915.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1958.43
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 832.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2528.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1915.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1915.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2592.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1958.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2592.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1927.93
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2592.94
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2592.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1927.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1677.79
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2592.94
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2592.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1915.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1915.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1958.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2226.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1693.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2501.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2675.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1958.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1915.73
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2592.94
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2013.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1958.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2501.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1927.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1677.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1693.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1693.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2501.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1927.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1927.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2226.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1915.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1958.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1915.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2287.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1677.79
            }
          ]
        }
      ]
    },
    {
      "description": "INSERT SZ3 16MM TIBIAL TS PLUS X3 POLY TRIATHLON",
      "code_information": [
        {
          "code": "SUP-5537-G-316",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6204,
          "discounted_cash": 4032.6,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4739.86
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4032.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3784.44
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5273.4
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5459.52
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5273.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3964.36
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4528.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3976.76
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4653
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4063.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6204
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5087.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4063.62
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4094.64
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5440.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5273.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3412.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5440.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3976.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3976.76
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3443.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5087.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4528.92
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3412.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5087.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3964.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4528.92
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1116.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5019.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5273.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3412.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1116.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3976.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3443.22
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5273.4
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5273.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5273.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5273.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4063.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4653
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4653
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5273.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4038.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4038.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5143.12
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3976.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4739.86
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4063.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5087.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3784.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4528.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3784.44
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1358.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4063.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5087.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5087.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3784.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3784.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3784.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3784.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5273.4
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4063.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3443.22
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5087.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3784.44
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5273.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3784.44
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4038.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4528.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3784.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3412.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4739.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4739.86
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1693.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3976.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4739.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3964.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4038.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3976.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5087.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3976.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3976.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3976.76
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3412.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3412.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5143.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3784.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3784.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4038.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4063.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3976.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5273.4
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4063.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3784.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3976.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5273.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4528.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5143.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3964.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3412.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5273.4
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5019.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6204,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4739.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3443.22
            }
          ]
        }
      ]
    },
    {
      "description": "ADHESIVE 0.7ML SKIN TOPICAL DERMABOND ADVANCED 12/BX",
      "code_information": [
        {
          "code": "SUP-DNX12",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 49.24,
          "discounted_cash": 32.01,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 30.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 30.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 30.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 40.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 30.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 30.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 30.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 43.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.61
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.61
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 30.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 32.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 30.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 39.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 40.82
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 31.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 30.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 30.92
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 13.44
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 32.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 49.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 31.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.61
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 32.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.85
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 27.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 32.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 30.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 32.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 27.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 32.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 36.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 43.18
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 30.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 30.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 40.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 27.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 31.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 32.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 49.24,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 27.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 39.84
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 43.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 31.96
            }
          ]
        }
      ]
    },
    {
      "description": "HEMOSTAT 2 X 3IN SURGICEL ORIGINAL ABSORBABLE",
      "code_information": [
        {
          "code": "SUP-1953S",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 159.65,
          "discounted_cash": 103.77,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 121.97
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 103.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 159.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 103.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 116.54
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 140.49
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 116.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.81
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.91
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 103.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.81
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 132.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.26
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 43.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 132.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 119.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 121.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 116.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 88.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 103.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 132.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 103.93
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 119.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 121.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.5
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 105.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 103.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 130.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 103.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 140.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 140.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 121.97
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 88.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 88.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 88.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 159.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 103.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 116.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 121.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 103.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 103.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 129.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 116.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 121.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 129.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 102.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 119.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 116.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 135.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 100.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 100.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 87.81
            }
          ]
        }
      ]
    },
    {
      "description": "ANCHOR GII QUICKANCHOR PLUS MITEK",
      "code_information": [
        {
          "code": "SUP-222983",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1155,
          "discounted_cash": 750.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 740.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 843.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 843.15
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 641.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 882.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 740.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 740.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 740.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 635.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1155
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 641.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 738.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 756.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 882.42
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 315.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 756.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 704.55
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 740.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 934.4
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 740.36
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 866.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1012.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 756.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 957.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 947.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 947.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 740.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 751.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 947.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 704.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 882.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 762.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 751.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1012.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 756.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 740.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 635.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 750.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 947.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 947.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 704.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 756.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 252.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 704.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 947.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 704.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 882.42
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 866.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 635.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 738.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 947.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 704.55
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 740.36
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 641.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 704.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 704.55
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 751.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 751.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 957.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 934.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 751.91
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 740.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 866.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 843.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 882.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 947.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 740.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 740.36
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 756.53
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 641.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 635.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 635.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 635.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 704.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 704.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 704.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 704.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 635.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 756.53
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1016.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 882.42
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 738.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 756.53
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 843.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 843.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 957.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 738.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 704.55
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 843.15
            }
          ]
        }
      ]
    },
    {
      "description": "KIT ACCESSORY AMS 800 ARTIFICIAL URINARY SPHINCTER",
      "code_information": [
        {
          "code": "SUP-720066-01",
          "type": "CDM"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4090.5,
          "discounted_cash": 2658.82,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2626.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2626.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3587.37
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 3599.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2249.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2568.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2626.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2626.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2626.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3476.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2585.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2658.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2270.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2568.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2585.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3476.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3354.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2654.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2662.92
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3476.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2568.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2654.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2626.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3125.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2568.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3476.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3354.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3125.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3125.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3354.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2662.92
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3476.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2585.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3067.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3391.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3354.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3354.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2568.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2568.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2270.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3354.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2654.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3125.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3067.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2585.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2662.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2626.1
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2699.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3476.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3354.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2568.83
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1116.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2249.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2568.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2662.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3476.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2270.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4090.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3587.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2626.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3476.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2986.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2986.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2249.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2249.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3354.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2654.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2568.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2662.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2986.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2270.23
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3476.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2249.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2249.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2986.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2585.2
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3476.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2626.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2626.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3125.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2568.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2585.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2568.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3125.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3476.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3391.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3309.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2585.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2249.78
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3476.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3391.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2626.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2568.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2986.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3067.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2986.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2568.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2626.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3309.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2585.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4090.5,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "LINER 36 X 58 4 10DEG DUR MAR",
      "code_information": [
        {
          "code": "SUP-122036558",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4583.25,
          "discounted_cash": 2979.11,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2937.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3501.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3345.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2543.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2795.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2937.86
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2543.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3501.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4583.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3345.77
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3345.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2983.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3895.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2520.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2520.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3799.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3758.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3799.51
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3895.76
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3895.76
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3024.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2520.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3002.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2937.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2937.86
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2928.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3895.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2928.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2795.78
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2520.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2937.86
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3895.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3501.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2795.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3758.27
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4033.26
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3895.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2795.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2795.78
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3002.03
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3895.76
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3758.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2937.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2937.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3895.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2983.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3002.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2520.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4019.51
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3895.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3345.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2520.79
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3895.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2795.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2983.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3758.27
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3758.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2795.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2928.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3002.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2937.86
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3895.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2520.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2795.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3758.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2795.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2937.86
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2795.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3437.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2937.86
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1251.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2937.86
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2543.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3758.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3345.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2795.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2928.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3002.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3501.6
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2795.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3707.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4019.51
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1003.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2937.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3437.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3437.44
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3895.76
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2979.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3002.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3002.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3501.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3707.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3501.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3895.76
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3002.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2543.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3799.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3758.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2983.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2983.7
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3345.77
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3895.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2795.78
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4583.25,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "LINER 40 X 56 4 10DEG ALTRX",
      "code_information": [
        {
          "code": "SUP-122140156",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2100,
          "discounted_cash": 1365,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1346.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1346.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1346.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1165.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1698.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1155
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2100
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1722
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1281
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1346.1
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1346.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1375.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1740.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1155
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1375.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1165.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1740.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1341.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1365
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1155
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1155
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1165.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1722
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1341.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1604.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1785
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1375.5
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1848
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1604.4
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1785
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1722
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1281
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1281
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1785
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1785
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1341.9
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1785
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1346.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1281
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1375.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1346.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1841.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1375.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1740.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1281
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1281
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1533
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1785
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1785
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1375.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1367.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1281
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1604.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1533
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1155
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 573.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1367.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1346.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1346.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1346.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1785
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1155
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1281
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1375.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1367.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1722
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1281
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1155
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1604.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1575
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1533
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1346.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1785
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1386
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1367.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1604.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1785
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1785
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1341.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1722
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1533
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1604.4
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1533
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1722
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1722
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1575
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1281
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1281
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1698.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1375.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1346.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1785
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1165.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1533
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1841.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1785
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 459.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1575
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1722
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1281
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1367.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1785
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1281
            }
          ]
        }
      ]
    },
    {
      "description": "ANCHOR 5.5MM SUTURE SELF PUNCH KNOTLESS BIOCOMP SWIVELOCK",
      "code_information": [
        {
          "code": "SUP-AR-2323KBCSP",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 312,
          "discounted_cash": 202.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 199.99
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 265.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 190.32
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 204.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 171.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 190.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 190.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 252.41
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 205.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 227.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 171.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 171.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 265.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 234
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 199.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 255.84
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 274.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 265.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 227.76
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 199.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 258.65
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 265.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 265.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 199.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 258.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 238.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 265.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 265.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 312,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 273.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 199.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 190.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 199.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 199.99
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 204.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 265.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 312,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 238.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 199.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 173.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 204.36
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 199.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 238.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 255.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 190.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 190.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 199.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 203.11
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 199.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 199.37
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 265.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 312,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 204.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 204.36
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 265.2
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 265.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 265.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 190.32
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 171.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 204.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 273.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 199.99
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 265.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 255.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 238.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 171.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 203.11
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 202.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 312
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 258.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 252.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 203.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 171.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 234
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 255.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 204.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 227.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 227.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 255.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 204.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 238.37
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 255.84
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 85.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 199.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 173.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 199.99
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 312,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 238.37
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 190.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 190.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 255.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 203.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 203.11
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 312,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 190.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 190.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 171.6
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 234
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 227.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 227.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 173.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 199.37
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 312,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 173.16
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 265.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 312,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 190.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 190.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 255.84
            }
          ]
        }
      ]
    },
    {
      "description": "KIT SPY-PHI PRODEDURE W/ DRAPE INDOCYANINE GREEN AND WATER",
      "code_information": [
        {
          "code": "SUP-HH9006",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1750,
          "discounted_cash": 1137.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1123.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1487.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1435
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1135.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 971.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1139.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1099
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1277.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1435
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1099
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1123.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1123.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1099
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1139.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1139.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 962.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1534.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1487.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 962.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1337
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1139.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1123.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 962.5
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1540
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1435
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 971.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1135.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1487.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1750,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1123.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1277.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1312.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1123.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1487.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1337
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1534.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1487.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1312.5
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1155
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1435
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1487.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1106
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1099
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1135.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1277.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1123.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1337
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1099
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1099
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1487.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1099
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1099
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1487.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1337
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1337
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 971.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1435
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1139.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1106
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1106
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1123.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1277.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1106
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1435
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1123.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1487.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 962.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1750
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1099
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 477.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 962.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1123.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1487.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1415.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1435
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1106
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 962.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1450.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1099
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1487.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1123.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1337
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1450.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1099
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1415.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1277.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1277.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1106
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1487.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 971.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1099
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1106
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1099
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1106
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1123.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1137.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1435
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1135.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 962.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1312.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1450.75
            }
          ]
        }
      ]
    },
    {
      "description": "MANIPULATOR INJECTOR UTERINE",
      "code_information": [
        {
          "code": "SUP-6003",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 290.57,
          "discounted_cash": 188.87,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 159.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 159.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 188.58
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 246.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 222
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 222
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 189.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 235.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 212.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 290.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.55
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 246.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 161.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 240.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.48
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 188.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 212.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 212.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 217.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.64
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 191.78
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 290.57,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 246.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 161.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.48
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 246.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 246.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 161.27
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 246.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 217.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 212.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 188.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 240.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 188.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 159.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 254.83
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 255.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 212.12
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 217.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 246.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 159.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 189.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 161.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 159.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 159.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 159.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.48
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 79.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 189.16
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 246.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 189.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 246.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 222
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 188.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 246.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 235.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 254.83
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 246.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 222
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 222
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 246.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 212.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 189.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 240.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 222
            }
          ]
        }
      ]
    },
    {
      "description": "RESTRICTED USE - PROBE RADIOFREQ F/ INTRACEPT INTRAOSSEOUS NERVE ABLATION SYS",
      "code_information": [
        {
          "code": "SUP-FG0043",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 13950,
          "discounted_cash": 9067.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10657.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8760.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7672.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10657.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10657.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10183.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8760.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11285.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8816.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8955.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10462.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11439
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11857.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8955.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10462.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11564.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8816.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11857.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 12234.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8760.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8760.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8955.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11564.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7672.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 12234.15
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13950,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8955.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10183.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3808.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8816.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10183.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8816.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8955.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10183.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7742.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11857.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8760.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9081.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11439
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8760.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11857.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7672.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7672.5
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 12276
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11439
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 9053.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8760.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8955.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10657.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11857.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10183.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8955.9
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 9207
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11857.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7672.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8955.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11857.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11564.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 9053.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10657.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 9053.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9081.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8955.9
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11857.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8760.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 9053.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11285.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9081.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11857.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8955.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11439
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8816.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8955.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 9067.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8816.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7742.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7672.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11857.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7742.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7742.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8760.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8760.6
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11857.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8760.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11439
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9081.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8955.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10462.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11439
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9081.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11439
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11439
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8760.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8760.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8816.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10657.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11857.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10183.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 13950
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8816.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7672.5
            }
          ]
        }
      ]
    },
    {
      "description": "MESH 1.6 X 2IN XLG PROLOOP PLUG W/ONLAY",
      "code_information": [
        {
          "code": "SUP-30903",
          "type": "CDM"
        },
        {
          "code": "C1781",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 498,
          "discounted_cash": 323.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 319.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 498
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 303.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 303.78
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 363.54
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 498,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 319.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 273.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 273.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 408.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 318.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 363.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 326.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 319.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 363.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 303.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 273.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 323.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 326.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 380.47
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 423.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 303.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 436.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 423.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 276.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 319.22
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 363.54
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 423.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 408.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 423.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 303.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 273.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 373.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 498,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 324.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 380.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 319.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 373.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 408.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 408.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 303.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 318.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 319.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 412.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 303.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 412.84
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 135.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 326.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 380.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 326.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 326.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 319.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 319.22
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 423.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 324.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 380.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 326.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 373.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 402.88
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 363.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 412.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 303.78
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 423.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 498,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 498,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 380.47
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 328.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 303.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 402.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 326.19
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 423.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 273.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 408.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 380.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 408.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 303.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 318.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 303.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 324.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 498,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 273.9
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 319.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 408.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 423.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 423.3
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 423.3
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 423.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 423.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 423.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 276.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 303.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 303.78
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 438.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 363.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 324.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 276.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 408.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 273.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 319.22
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 498,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 319.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 276.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 318.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 324.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 319.22
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 498,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 423.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 326.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 436.75
            }
          ]
        }
      ]
    },
    {
      "description": "COLLECTOR TISSUE AUTOLOGOUS GRAFTNET",
      "code_information": [
        {
          "code": "SUP-ABS-1050",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1155,
          "discounted_cash": 750.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 741.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1012.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 725.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 947.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 741.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 882.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 725.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 725.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 741.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 741.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 934.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 882.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 729.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 635.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 866.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 641.03
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 750.75
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1016.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 843.15
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 725.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 882.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 947.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 749.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 934.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 635.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 725.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 741.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 725.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 843.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 882.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 843.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 947.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 751.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 751.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 751.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 741.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 641.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 947.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 957.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 725.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 729.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 729.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 741.51
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 762.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 635.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 729.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 957.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 882.42
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 866.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 641.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 947.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 725.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 882.42
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 843.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 957.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 947.1
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1155,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 866.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 741.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 729.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 725.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 749.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 843.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 641.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 635.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 741.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 635.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 751.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 729.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 741.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 725.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 725.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 729.96
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 635.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 947.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 725.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 725.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 741.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1012.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 749.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 749.6
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 315.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 635.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 947.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 751.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 729.96
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 981.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 843.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1155
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 741.51
            }
          ]
        }
      ]
    },
    {
      "description": "SUTURE 3-0 30CM STRATAFIX SPIRAL MONOCRYL SXMP2B408 PS-2",
      "code_information": [
        {
          "code": "SUP-SXMP2B408",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 66.94,
          "discounted_cash": 43.51,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.82
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 66.94,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 58.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 66.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.9
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 18.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 43.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 54.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 43.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.87
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 37.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 54.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.98
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 43.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 37.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 43.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 37.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51.14
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 44.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 43.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.98
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 37.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.9
            }
          ]
        }
      ]
    },
    {
      "description": "SUTURE 7-0 30IN PROLENE EP8755H BV175-8 BLUE",
      "code_information": [
        {
          "code": "SUP-EP8755H",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 70.41,
          "discounted_cash": 45.77,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 39.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 56.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.79
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 58.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 70.41,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 39.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 45.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 52.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 52.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 56.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 45.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 39.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.22
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 19.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 58.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.22
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 61.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 45.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.73
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.73
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 52.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.74
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 61.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 39.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 58.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 70.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 45.7
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 46.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 61.75
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.79
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.79
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.22
            }
          ]
        }
      ]
    },
    {
      "description": "MESH 3 X 6IN SURGCL PROLENE",
      "code_information": [
        {
          "code": "SUP-ETPMII",
          "type": "CDM"
        },
        {
          "code": "C1781",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 122.26,
          "discounted_cash": 79.47,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 78.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 80.08
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 78.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 79.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 78.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 78.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 93.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 93.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 78.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 78.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 79.59
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 80.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 80.08
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 78.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 67.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 79.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.92
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.92
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 78.37
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.92
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 107.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.92
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 79.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 78.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 101.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 80.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 80.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 93.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.92
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 93.41
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 101.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 91.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 78.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 91.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 93.41
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 80.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 67.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 93.41
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 78.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 67.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 80.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 107.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 78.37
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 107.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 79.59
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.24
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 91.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 67.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 98.91
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.92
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 122.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 79.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 98.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 74.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 80.08
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 122.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 101.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 103.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 80.08
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 33.38
            }
          ]
        }
      ]
    },
    {
      "description": "MESH 3IN SM CIRCLE W/PTFE VENTRIO",
      "code_information": [
        {
          "code": "SUP-0010213",
          "type": "CDM"
        },
        {
          "code": "C1781",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1380.3,
          "discounted_cash": 897.19,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 884.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 841.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1210.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 759.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 884.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 884.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1035.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 882.01
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1173.26
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 904.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 759.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1054.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 766.07
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 884.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1054.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1007.62
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1035.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1210.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1173.26
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 841.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1144.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1131.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1131.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1131.85
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 376.82
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1054.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 884.77
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1173.26
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1214.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 898.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 884.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1173.26
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 897.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 841.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 841.98
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 759.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1131.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1131.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 841.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 841.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 841.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1173.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1007.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1131.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1035.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 882.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 898.58
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 302.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 898.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 904.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1173.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 898.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1144.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 759.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 884.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1173.26
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 911
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1144.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1007.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1173.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1007.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 766.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1131.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1173.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 759.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 904.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1054.55
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 766.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 882.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 841.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 898.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1116.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 904.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 904.1
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1116.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 884.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 884.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 884.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1131.85
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 882.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 884.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 904.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1173.26
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1173.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 841.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 904.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1007.62
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1173.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1380.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 841.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1173.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 759.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 904.1
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1173.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1054.55
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 841.98
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 759.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 884.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1007.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 841.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 841.98
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 766.07
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1380.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1054.55
            }
          ]
        }
      ]
    },
    {
      "description": "MATRIX 5 X 5CM WOUND CLOSURE SUPRATHEL CW 5/PK PER SQ CM",
      "code_information": [
        {
          "code": "SUP-250505-US",
          "type": "CDM"
        },
        {
          "code": "A2011",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 180,
          "discounted_cash": 117,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 137.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 137.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 113.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 117.18
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 180,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 180,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 115.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 115.56
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 115.56
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 115.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 137.52
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 135
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 113.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 113.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 147.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 113.76
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 180,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 158.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 135
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 115.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 137.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 180,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 113.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 99.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 180,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 118.8
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 157.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 180,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 180,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 113.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 180,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 117.18
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 131.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 145.62
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 135
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 131.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 180,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 117.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 145.62
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 180,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 180,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 180,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 131.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 149.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 147.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 147.6
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 49.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 113.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 115.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 131.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 180
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 149.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 180,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 113.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 115.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 131.4
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 147.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 180,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 180,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 147.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 147.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 180,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 99.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 149.22
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 137.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 115.56
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 180,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 180,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 180,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 99.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 115.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 180,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 117
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 153
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 99
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 147.6
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 180,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 147.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 117.18
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 180,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 115.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 115.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 137.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 131.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 115.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 157.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 99.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 180,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 117.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 180,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "KIT BLADE HOOK AND TRIANGLE FOR ECTR ENDOTRAC",
      "code_information": [
        {
          "code": "SUP-3056-6",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1263,
          "discounted_cash": 820.95,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 964.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 964.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1035.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 793.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 819.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1021.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 822.21
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1073.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 921.99
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 820.95
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1073.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1047.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 793.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 822.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 810.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 810.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 810.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 921.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 798.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 798.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1073.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1047.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 700.97
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1073.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 694.65
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1263,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 964.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 964.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 694.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 793.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 694.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 700.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 793.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 793.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 798.22
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1073.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1073.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 694.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 798.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1107.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 810.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 921.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 921.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 700.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1035.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 793.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1035.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 819.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1035.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 694.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1073.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 798.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 810.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 822.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 921.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 921.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1047.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 793.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1073.55
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 833.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 694.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1035.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1035.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1035.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 793.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 793.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 798.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 822.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 810.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 810.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1107.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1035.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 793.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 793.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 810.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 810.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 947.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 947.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1021.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 694.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 700.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 819.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 798.22
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1111.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 964.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 798.22
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 947.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 810.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 810.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1263
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 793.16
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1073.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 964.93
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1073.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1073.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 822.21
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 344.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 810.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 793.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 819.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1073.55
            }
          ]
        }
      ]
    },
    {
      "description": "MATRIX 3X 7CM THIN ALLODERM SELECT PER SQ CM",
      "code_information": [
        {
          "code": "SUP-141621",
          "type": "CDM"
        },
        {
          "code": "Q4116",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 155.13,
          "discounted_cash": 100.83,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.59
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.32
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 100.99
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 136.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.86
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 100.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 125.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.04
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 118.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.21
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.04
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 86.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.21
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 118.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.24
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 42.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.86
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 102.39
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 118.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 86.1
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 136.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.04
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.86
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.86
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 116.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 100.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 100.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 128.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 127.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.59
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.04
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 136.51
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 118.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.86
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.86
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 125.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 100.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 86.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 128.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 155.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.59
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 116.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 131.86
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 85.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 128.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 86.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 118.52
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 116.35
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 118.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 99.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 113.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 155.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 100.99
            }
          ]
        }
      ]
    },
    {
      "description": "FIBER 300 MICRON LASER DISP HIFLEX",
      "code_information": [
        {
          "code": "SUP-11100",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1575,
          "discounted_cash": 1023.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1011.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1022.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1025.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 989.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1149.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1338.75
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1039.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1203.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1203.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1011.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1011.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1011.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1291.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1011.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1274.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1291.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1291.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1291.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 429.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 995.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 995.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 995.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1011.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1149.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1575
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 989.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 989.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1203.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1011.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1338.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1338.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1181.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1149.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1291.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 989.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 995.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1023.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1011.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 866.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 866.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 874.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1305.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 989.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1149.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1022.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1022.18
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1575,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 866.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 866.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1291.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1022.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1011.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1149.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 989.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1338.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1149.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1291.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 989.1
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1386
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 866.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 995.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 995.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 995.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1338.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1181.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1011.15
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1338.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1338.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 866.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1338.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 989.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1025.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1203.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 866.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 874.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 874.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1025.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1381.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 995.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1305.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1291.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 989.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1338.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1203.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1203.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 989.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1274.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1381.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1338.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 989.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1338.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1338.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1181.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1025.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1011.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1011.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 989.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1025.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 874.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1305.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 989.1
            }
          ]
        }
      ]
    },
    {
      "description": "FORCEP 5MM 32CM GRASPER CVD ENDOSCOPIC ENDOPATH",
      "code_information": [
        {
          "code": "SUP-5DSG",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 137.23,
          "discounted_cash": 89.2,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 113.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 104.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 104.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.48
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 102.92
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 89.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.18
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 102.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 113.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.53
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 89.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 76.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 89.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 102.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 104.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 89.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 89.06
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 120.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 104.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 76.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 89.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 111.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.73
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 90.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 89.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 76.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 120.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 89.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 89.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 76.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 89.34
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.65
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 137.23,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 104.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 113.76
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 120.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 111.02
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 37.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 104.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 137.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 86.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.65
            }
          ]
        }
      ]
    },
    {
      "description": "NAIL 11 X 21CM ANKLE ARTHRODESIS PHOENIX",
      "code_information": [
        {
          "code": "SUP-14-440221",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5677.65,
          "discounted_cash": 3690.47,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3639.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3639.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3122.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3151.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3463.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3463.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4144.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4706.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3463.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3639.37
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3747.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3122.71
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5677.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4979.3
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4826
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4655.67
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4826
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4826
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4144.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3122.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3718.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3463.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3628.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3628.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3696.15
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1550
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3718.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3639.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3151.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3696.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4826
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4655.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3463.37
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4826
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4826
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4337.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4826
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4337.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4655.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4258.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3628.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4337.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4144.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3122.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4706.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3463.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3696.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3718.86
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4996.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4655.67
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3463.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4655.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4593.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4826
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4258.24
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4826
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3639.37
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1243.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3463.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3696.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4826
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4655.67
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3690.47
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3463.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4655.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4593.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3718.86
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4826
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4826
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4826
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3639.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4337.72
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4979.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3122.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3122.71
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3718.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4337.72
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4258.24
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4655.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3463.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3151.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3463.37
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3639.37
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3718.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3639.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3639.37
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3463.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4706.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3463.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3122.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3639.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4144.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3718.86
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3639.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4144.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3718.86
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4826
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4337.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4144.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3151.1
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1021.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3639.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3696.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5677.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3628.02
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1021.98
            }
          ]
        }
      ]
    },
    {
      "description": "IMPLANT 22MM X 44MM BOVINE TYPE I COLLAGEN CYLINDRICAL",
      "code_information": [
        {
          "code": "SUP-1000",
          "type": "CDM"
        },
        {
          "code": "C1763",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 17100,
          "discounted_cash": 11115,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10961.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10961.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13833.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10431
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13064.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12483
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13064.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14175.9
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10961.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10431
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14535
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14535
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9490.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9490.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14175.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11200.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 3078
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10431
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14535
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13064.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10961.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9490.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11200.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10431
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9490.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9405
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14535
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10961.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10431
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14535
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14535
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 3744.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11132.1
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12825
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11200.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11200.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10961.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14996.7
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 15048
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14022
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10431
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10926.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11132.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10961.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10961.1
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14535
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13064.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9405
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14535
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10431
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14022
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14022
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14022
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 3078
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9405
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14535
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10961.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12483
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11200.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11200.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 11115
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 17100
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10431
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13833.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13064.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10961.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14535
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12483
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10431
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9405
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12825
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10961.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9405
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10926.9
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11132.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12483
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11200.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14535
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14535
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14022
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11132.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10431
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12825
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 11286
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 11200.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10926.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12483
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14175.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10431
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11132.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9405
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14022
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10926.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14022
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10961.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12483
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9405
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14535
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10431
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 10431
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14996.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13064.4
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14535
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4668.3
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 17100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14022
            }
          ]
        }
      ]
    },
    {
      "description": "IMPLANT 5 X 7IN COLLAGEN DURAMATRIX ONLAY PLUS",
      "code_information": [
        {
          "code": "SUP-DMOP57",
          "type": "CDM"
        },
        {
          "code": "C1763",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5714.49,
          "discounted_cash": 3714.42,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3662.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3662.99
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4685.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3142.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4857.32
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4857.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4365.87
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4285.87
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4857.32
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4857.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4857.32
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3742.99
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4857.32
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5028.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4365.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3662.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3171.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3742.99
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3171.54
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3771.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4171.58
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4857.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4285.87
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3485.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4171.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3485.84
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4857.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3171.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3720.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5011.61
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3662.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3142.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4685.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4685.88
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4857.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4171.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5011.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3742.99
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1028.61
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4857.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4737.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4685.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3720.13
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3742.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4171.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4685.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4737.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3485.84
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1028.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3142.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3142.97
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3714.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3662.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3142.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3742.99
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4857.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3720.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4623.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4365.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4171.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4171.58
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4685.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3651.56
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3742.99
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3662.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3142.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3171.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3485.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4685.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3485.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3662.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3720.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3662.99
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1251.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3662.99
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3142.97
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4285.87
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4857.32
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4365.87
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4685.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3485.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3485.84
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5714.49
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3485.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3720.13
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1560.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3485.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3485.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3485.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3742.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3742.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4737.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3651.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3662.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3662.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4365.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4365.87
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4857.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3651.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3485.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3651.56
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4857.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3485.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4623.02
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5714.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3662.99
            }
          ]
        }
      ]
    },
    {
      "description": "BOLT 10 X 40MM STD FIXED TI EXPEDIUM",
      "code_information": [
        {
          "code": "SUP-175422040",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 960,
          "discounted_cash": 624,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 733.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 615.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 787.2
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 585.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 816
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 532.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 624.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 615.36
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 528
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 816
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 844.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 615.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 787.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 841.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 960
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 816
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 628.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 733.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 585.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 624
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 816
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 720
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 624.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 700.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 841.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 816
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 960,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 532.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 816
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 960,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 628.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 816
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 628.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 615.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 528
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 585.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 776.64
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 960,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 816
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 816
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 532.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 585.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 585.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 628.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 262.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 628.8
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 816
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 615.36
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 816
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 700.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 795.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 787.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 585.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 528
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 628.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 960,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 733.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 733.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 528
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 528
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 624.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 816
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 795.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 787.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 585.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 628.8
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 633.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 700.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 700.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 795.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 585.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 624.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 628.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 585.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 816
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 585.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 585.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 585.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 960,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 960,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 816
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 528
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 532.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 787.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 624.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 615.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 700.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 528
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 787.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 733.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 615.36
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 720
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 613.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 613.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 776.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 615.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 787.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 585.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 720
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 615.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 615.36
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 615.36
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 700.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 787.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 613.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 613.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 733.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 615.36
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 960,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 1.5 X 5MM SELF-TAP TI BRONZE MATRIXMIDFACE",
      "code_information": [
        {
          "code": "SUP-04.503.205.01",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 217.8,
          "discounted_cash": 141.57,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 139.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 166.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 142.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 119.79
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.13
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 132.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 141.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 178.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 119.79
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 178.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 132.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 158.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 158.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 142.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 180.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 132.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 142.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 191.01
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 158.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 120.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 180.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 120.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 132.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 139.61
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 139.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 158.99
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 166.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 139.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 178.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 178.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 132.86
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 119.79
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 119.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 166.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 139.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 132.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 163.35
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.13
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 163.35
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 141.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 178.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 178.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 132.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 139.17
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 166.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 158.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 158.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 139.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 132.86
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 142.66
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 191.66
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 142.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 166.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 132.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 141.79
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 59.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 176.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.13
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 132.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 139.61
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 141.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 176.2
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 139.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 139.61
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 180.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 178.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 141.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 142.66
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 139.61
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 143.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 132.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 178.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 132.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 132.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 141.79
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 139.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 139.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 166.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 120.88
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 139.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 120.88
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 119.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 119.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 119.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 163.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 217.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 139.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 185.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 142.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 142.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 139.17
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 217.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 191.01
            }
          ]
        }
      ]
    },
    {
      "description": "BLADE 10.35 X 110MM HELICAL CANN FEN TI PROX TFN-ADVANCED",
      "code_information": [
        {
          "code": "SUP-04.038.410",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1897.2,
          "discounted_cash": 1233.18,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1449.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1449.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1199.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1043.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1191.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1235.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1384.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1384.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1897.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1555.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1422.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1555.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1191.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1235.08
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1612.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1663.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1612.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1043.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1191.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1555.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1191.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1612.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1612.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1384.96
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1612.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1231.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1612.62
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1252.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1052.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1555.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1043.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1191.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1449.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1572.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1199.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1572.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1235.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1218
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1449.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1218
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1052.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1043.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1534.83
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1612.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1191.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1231.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1422.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1422.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1612.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1191.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1191.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1043.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1218
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1384.96
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1612.62
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 517.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1218
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1218
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1612.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1199.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1572.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1555.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1555.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1231.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1231.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1191.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1218
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1555.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1191.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1235.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1218
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1199.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1199.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1449.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1199.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1384.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1191.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1191.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1235.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1218
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1043.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1612.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1663.84
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1669.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1199.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1199.03
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1612.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1218
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1449.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1043.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1052.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1052.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1534.83
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1233.18
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1897.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1218
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1218
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1384.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1191.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1218
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1555.7
            }
          ]
        }
      ]
    },
    {
      "description": "KIT RECHARGER RC PERCEPT",
      "code_information": [
        {
          "code": "SUP-RS6230",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8521.5,
          "discounted_cash": 5538.97,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5470.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6510.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5470.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6987.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5351.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6220.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7243.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5385.59
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7498.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7243.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6510.43
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7243.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5385.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6220.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5351.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7243.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4686.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7064.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6510.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5470.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5470.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4686.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7064.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5351.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5547.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4686.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4686.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4686.83
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7243.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6987.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5385.59
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7243.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4729.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5351.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6987.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6391.13
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6391.13
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2326.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4729.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7064.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5470.8
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5624.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5470.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4686.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6987.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5351.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5351.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5547.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5351.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5351.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5547.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5470.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6987.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5351.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6220.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6220.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4729.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5351.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5385.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5385.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6987.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5351.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5351.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5530.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5547.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8521.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6510.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7243.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5385.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6510.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5385.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6220.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6893.89
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7243.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5530.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6987.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5547.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7473.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5470.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4686.83
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7243.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5470.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5470.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6510.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6391.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6220.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4729.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5530.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7473.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7243.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6987.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8521.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5351.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5530.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6893.89
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5538.98
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7243.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5470.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5470.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5385.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7243.28
            }
          ]
        }
      ]
    },
    {
      "description": "HC Perc Transcath Closure Paravalvular Leak Aortic Valve",
      "code_information": [
        {
          "code": "PX-48000065",
          "type": "CDM"
        },
        {
          "code": "93591",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 16533,
          "discounted_cash": 10746.45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10448.86
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10762.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9093.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12069.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9093.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10762.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12631.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10448.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9093.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12399.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 14549.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13557.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13557.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 10911.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9093.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13705.86
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10762.98
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4513.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13557.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13375.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10762.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12399.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9093.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10448.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13705.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9093.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13557.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12631.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12069.09
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10448.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10448.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13375.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10448.86
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 16533
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13705.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 10746.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10448.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14499.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12399.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12069.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13557.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12631.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 16533,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12631.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9175.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12069.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9175.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13557.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13557.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10448.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10762.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12069.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12069.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9175.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13557.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9175.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12631.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14499.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9093.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12631.21
            }
          ]
        }
      ]
    },
    {
      "description": "Trach Cuffless Fenestrated Size 6",
      "code_information": [
        {
          "code": "PX-CH-2M6DCFN",
          "type": "CDM"
        },
        {
          "code": "A7520",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 75.38,
          "discounted_cash": 49,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 75.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.39
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.39
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.07
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.46
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 66.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 66.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.07
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.39
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 49.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.81
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.54
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 60.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.81
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 41.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 41.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 41.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 60.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.07
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.07
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 66.11
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 20.58
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.07
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.07
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.64
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.64
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.46
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.07
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.64
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 41.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.03
            }
          ]
        }
      ]
    },
    {
      "description": "Hand Antiseptic W/ Moisturizer Avagard D Instant Antiseptic",
      "code_information": [
        {
          "code": "PX-CH-889221",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.11,
          "discounted_cash": 2.67,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2.71
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 3.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.68
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.49
            }
          ]
        }
      ]
    },
    {
      "description": "Pleurx/ Ascites Drainage Kit 500ml",
      "code_information": [
        {
          "code": "PX-CH-DB50-7500",
          "type": "CDM"
        },
        {
          "code": "A7048",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 81.25,
          "discounted_cash": 52.81,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 52.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 66.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 59.31
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 65.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 52.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 52.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 60.94
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 44.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 44.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 67.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 60.94
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 52.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 62.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 71.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 52.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 44.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 59.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 44.69
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 66.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 62.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 52.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 44.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 62.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 62.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 52.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 59.31
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 52.89
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 52.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 59.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 71.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 60.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 52.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 66.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 67.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 52.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 66.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 62.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.06
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 53.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 44.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 67.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 52.16
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 71.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 66.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 62.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 66.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 66.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 52.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 66.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 52.16
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 22.18
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 59.31
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 69.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 52.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 52.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 44.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 81.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 52.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 59.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 65.73
            }
          ]
        }
      ]
    },
    {
      "description": "Tape Measure Paper 36 In",
      "code_information": [
        {
          "code": "PX-CH-GF17-1335",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.07,
          "discounted_cash": 0.05,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.07,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Wrap Self-Closure Bandage 3 in X 4 Yds Cardinal",
      "code_information": [
        {
          "code": "PX-CH-IMC2359-303",
          "type": "CDM"
        },
        {
          "code": "A6449",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.06,
          "discounted_cash": 0.69,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.87
            }
          ]
        }
      ]
    },
    {
      "description": "Briefs Heavy Absorbency Large Prevail Pm Extended Wear",
      "code_information": [
        {
          "code": "PX-CH-IMCFQNTB0131",
          "type": "CDM"
        },
        {
          "code": "A4520",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.61,
          "discounted_cash": 1.05,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.41
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.61,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.61
            }
          ]
        }
      ]
    },
    {
      "description": "Alginate Silver Reliamed 18 in Rope",
      "code_information": [
        {
          "code": "PX-CH-IMCZSCA18RRF",
          "type": "CDM"
        },
        {
          "code": "A6199",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.69,
          "discounted_cash": 6.95,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.02
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.93
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.96
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.96
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.09
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.09
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.09
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.69,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.93
            }
          ]
        }
      ]
    },
    {
      "description": "Blood Collection Set 23g X 3/4 in Winged Safety",
      "code_information": [
        {
          "code": "PX-CH-KN225307",
          "type": "CDM"
        },
        {
          "code": "A4215",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.76,
          "discounted_cash": 1.14,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.76,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.5
            }
          ]
        }
      ]
    },
    {
      "description": "1 Pc Pre Cut Ext Wear Cvx Uro 1 in Premier",
      "code_information": [
        {
          "code": "PX-CH-HO8484",
          "type": "CDM"
        },
        {
          "code": "A4430",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.84,
          "discounted_cash": 4.45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Gauze Drsg Bordered Cover Covrsite 6 in X 6 In",
      "code_information": [
        {
          "code": "PX-CH-UN59714300",
          "type": "CDM"
        },
        {
          "code": "A6219",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.34,
          "discounted_cash": 1.52,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.94
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.89
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.54
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.29
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.94
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.99
            }
          ]
        }
      ]
    },
    {
      "description": "Wound Drain Collector Large Non-Sterile",
      "code_information": [
        {
          "code": "PX-CH-HO9778",
          "type": "CDM"
        },
        {
          "code": "A6154",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 25.59,
          "discounted_cash": 16.63,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 20.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 22.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 20.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 22.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.17
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 21.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 19.19
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14.2
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 19.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.17
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 19.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.75
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 22.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 16.89
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 21.21
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 21.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 18.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 21.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 25.59
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 16.17
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 25.59,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter External All Silicone Small 25 Mm Standard Wear",
      "code_information": [
        {
          "code": "PX-CH-HO97525",
          "type": "CDM"
        },
        {
          "code": "A4349",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.71,
          "discounted_cash": 1.11,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.71,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.45
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.28
            }
          ]
        }
      ]
    },
    {
      "description": "Leg Bag Latex Free 19 Oz W Flip-Flo Valve",
      "code_information": [
        {
          "code": "PX-CH-HO9814",
          "type": "CDM"
        },
        {
          "code": "A4335",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.7,
          "discounted_cash": 4.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter Silicone Elastomer 20 Fr 30 Cc",
      "code_information": [
        {
          "code": "PX-CH-BA123620A",
          "type": "CDM"
        },
        {
          "code": "A4338",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.28,
          "discounted_cash": 0.83,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 3.17,
          "discounted_cash": 2.06,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.63
            }
          ]
        }
      ]
    },
    {
      "description": "HH St Maintenance Visit",
      "code_information": [
        {
          "code": "PX-44100106",
          "type": "CDM"
        },
        {
          "code": "G0161",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 66.35,
          "discounted_cash": 43.13,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.69
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.4
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.4
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 18.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.6
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 43.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 66.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 66.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 36.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 66.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 66.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 66.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 58.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 58.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 66.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 66.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 66.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 66.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 49.76
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 53.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 66.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.93
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 36.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 66.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 53.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.19
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 36.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 66.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 66.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 66.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 66.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 66.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 66.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 49.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.44
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 58.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 36.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 66.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 49.76
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 62.15,
          "discounted_cash": 43.13,
          "payers_information": [
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.15,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "Wrap Self-Closure Bandage 2 in Econo-Fix",
      "code_information": [
        {
          "code": "PX-CH-HA51200000",
          "type": "CDM"
        },
        {
          "code": "A6449",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.63,
          "discounted_cash": 0.41,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.63,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "Barrier Ring Moldable Brava 2 Mm Thickness",
      "code_information": [
        {
          "code": "PX-CH-SW120307",
          "type": "CDM"
        },
        {
          "code": "A4385",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.17,
          "discounted_cash": 4.01,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.68
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.43
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.11
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.07
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.11
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Wrap Paste Zinc-Oxide 3 in Unna Boot Reliamed",
      "code_information": [
        {
          "code": "PX-CH-DN46-334",
          "type": "CDM"
        },
        {
          "code": "A6456",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.47,
          "discounted_cash": 3.56,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.47,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Pouch Sensura Mio Flex Yellow",
      "code_information": [
        {
          "code": "PX-CH-CO12283",
          "type": "CDM"
        },
        {
          "code": "A4425",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.91,
          "discounted_cash": 3.19,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.73
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.91,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Tray Driveline Management Lvad 9 Day",
      "code_information": [
        {
          "code": "PX-CH-TRS-DT18340",
          "type": "CDM"
        },
        {
          "code": "CH-TRS-DT18340",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 29.65,
          "discounted_cash": 19.27,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 23.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 19.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 26.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 19.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.31
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 23.99
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 22.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 29.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 19.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 19.24
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 29.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 22.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.74
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.2
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 19.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 22.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.04
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.04
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.58
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 8.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.46
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 19.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 25.2
            }
          ]
        }
      ]
    },
    {
      "description": "Syringe/Needle TB 1cc 25 G X 5/8 in Safety",
      "code_information": [
        {
          "code": "PX-CH-BD305554",
          "type": "CDM"
        },
        {
          "code": "A4657",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.7,
          "discounted_cash": 0.45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.7,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Fsed Basic Metabolic Panel Calcium Total",
      "code_information": [
        {
          "code": "PX-30101198",
          "type": "CDM"
        },
        {
          "code": "80048",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 56,
          "discounted_cash": 36.4,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 36.96
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 49.28
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 45.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 31.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.88
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 56,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.23,
              "estimated_amount": 9.23
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.88
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 8.46,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.88,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 46.42
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 31.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 46.42
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.39
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.39
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.92
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 46.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 45.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 36.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 56,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.23,
              "estimated_amount": 9.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 49.11
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.73,
              "estimated_amount": 31.73
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.39
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 15.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.39
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.23,
              "estimated_amount": 9.23
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 56,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 56
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 42
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 31.08
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.46,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.46
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 31.08
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 49.11
            }
          ],
          "minimum": 8.46,
          "maximum": 31.73
        }
      ]
    },
    {
      "description": "HC Fsed Urine Analysis Dipstick Automated",
      "code_information": [
        {
          "code": "PX-30700020",
          "type": "CDM"
        },
        {
          "code": "81003",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 62,
          "discounted_cash": 40.3,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 54.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 46.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 51.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.44,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.28,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.44,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.37
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 40.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.44,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 16.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 54.37
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 51.4
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.84
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.36
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 62
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 54.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.18
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 46.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.36
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 50.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 46.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.84
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.28,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.8
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.36
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 2.25,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 2.36,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 51.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.44,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.44,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.44,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.44,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.44,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.1
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.44,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.44,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.44,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.37
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 40.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.44,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.28,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.44,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.44,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.44,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.44,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.25,
              "estimated_amount": 2.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 50.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.44,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.7
            }
          ],
          "minimum": 2.25,
          "maximum": 8.44
        }
      ]
    },
    {
      "description": "Huber Infusion Set Gripper Plus 20g X 3/4 In",
      "code_information": [
        {
          "code": "PX-CH-BRSD21-2767",
          "type": "CDM"
        },
        {
          "code": "A4212",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11.52,
          "discounted_cash": 7.49,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 10.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.79
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.39
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 11.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.79
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.79
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.52,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "1 Pc Ctf Std Wear Deep Cvx Up to 1 11/16 in Mio",
      "code_information": [
        {
          "code": "PX-CH-CO16778",
          "type": "CDM"
        },
        {
          "code": "A4389",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.45,
          "discounted_cash": 5.49,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.44
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            }
          ]
        }
      ]
    },
    {
      "description": "Heel Protector Medium W/ Foam Pad",
      "code_information": [
        {
          "code": "PX-CH-PO6224M",
          "type": "CDM"
        },
        {
          "code": "E0191",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 16.7,
          "discounted_cash": 10.85,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.72
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.19
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.19
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.69
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.72
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 11.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 16.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.2
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.69
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.27
            }
          ]
        }
      ]
    },
    {
      "description": "Finger Nail Clipper Without File Box Only!!!!!",
      "code_information": [
        {
          "code": "PX-CH-NWFNC1",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.77,
          "discounted_cash": 4.4,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.77,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.96
            }
          ]
        }
      ]
    },
    {
      "description": "Lotion Hand Remedy 4 Oz",
      "code_information": [
        {
          "code": "PX-CH-MSC094424",
          "type": "CDM"
        },
        {
          "code": "A6250",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.68,
          "discounted_cash": 4.99,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.87
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.87
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.87
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.37
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.85
            }
          ]
        }
      ]
    },
    {
      "description": "FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-10009",
          "type": "CDM"
        },
        {
          "code": "J3490",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 34.65,
          "discounted_cash": 22.52,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.56
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.83,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.03
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.9
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 22.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.9
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.83,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.47
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 30.49
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.72
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.83,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.83,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.06
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.83,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.41
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 22.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.29
            }
          ],
          "minimum": 1.83,
          "maximum": 1.83
        }
      ]
    },
    {
      "description": "GENTAMICIN 80 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK",
      "drug_information": {
        "unit": "50",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-10111",
          "type": "CDM"
        },
        {
          "code": "J1580",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 68.2,
          "discounted_cash": 44.33,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 44.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.43,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.92
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 51.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 44.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.43,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.1
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 44.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.43,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.92
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 55.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.39,
              "estimated_amount": 6.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.43,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.39,
              "estimated_amount": 6.39
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 59.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 51.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.43,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.1
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.43,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.43,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 55.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.39,
              "estimated_amount": 6.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 44.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.43,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 56.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.43,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.39,
              "estimated_amount": 6.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 56.54
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.43,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.43,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 59.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.43,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 51.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.1
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 56.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.1
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.43,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 60.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.92
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.43,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.1
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 45.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 49.79
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.43,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 55.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 44.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.1
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 68.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.43,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 43.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 44.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.43,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.39,
              "estimated_amount": 6.39
            }
          ],
          "minimum": 6.39,
          "maximum": 7.43
        }
      ]
    },
    {
      "description": "ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLUTION",
      "drug_information": {
        "unit": ".5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-10358",
          "type": "CDM"
        },
        {
          "code": "Q9968",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 520.65,
          "discounted_cash": 338.42,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.26
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 286.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 114.5,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 114.5,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 114.5,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 431.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 329.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.26
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 114.5,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 114.5,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 329.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 380.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 380.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 421.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 114.5,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 426.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 286.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 520.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 426.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 114.5,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 343.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 520.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 338.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 114.5,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 397.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 114.5,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 114.5,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 380.07
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 338.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.26
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 390.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 380.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 520.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 520.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 426.93
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 458.17
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 520.65,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 456.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 114.5,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 380.07
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 114.5,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 338.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 286.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 329.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 390.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 426.93
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 390.49
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 520.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 397.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 286.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 286.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 397.78
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 114.5,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 431.62
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 338.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 329.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 520.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 520.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 520.65,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 520.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 520.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 426.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 329.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 329.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 114.5,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 114.5,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 380.07
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 114.5,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 397.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 338.94
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 142.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 329.05
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 397.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 286.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 329.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 114.5,
              "estimated_amount": 114.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 431.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 338.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 397.78
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 334.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 456.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 286.36
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 442.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 426.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 421.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 426.93
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 426.93
            }
          ],
          "minimum": 114.5,
          "maximum": 114.5
        }
      ]
    },
    {
      "description": "KETOCONAZOLE 2 % TOPICAL CREAM",
      "drug_information": {
        "unit": "15",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-10368",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 63.6,
          "discounted_cash": 41.34,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.83
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.72
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.06
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.2
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.15
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 41.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.4
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 55.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 63.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.98
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.06
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 41.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.94
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.4
            }
          ]
        }
      ]
    },
    {
      "description": "MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-10491",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.1,
          "discounted_cash": 0.06,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
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              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.06
            }
          ]
        }
      ]
    },
    {
      "description": "METOLAZONE 5 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-10588",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11.35,
          "discounted_cash": 7.38,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
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              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.29
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.29
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.29
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.31
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 11.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.31
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.3
            }
          ]
        }
      ]
    },
    {
      "description": "DIAZEPAM 5 MG/ML INJECTION SYRINGE",
      "drug_information": {
        "unit": "0.5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-106278",
          "type": "CDM"
        },
        {
          "code": "J3360",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 72.65,
          "discounted_cash": 47.22,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.96
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 58.77
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.75
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.91
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 63.93
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 60.23
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.3,
              "estimated_amount": 15.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.57
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.96
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 63.71
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 58.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 54.49
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.75
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.3,
              "estimated_amount": 15.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 60.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 47.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 54.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.3,
              "estimated_amount": 15.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.3,
              "estimated_amount": 15.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 19.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.75
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 47.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.57
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 54.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 60.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 63.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 53.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 72.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.3,
              "estimated_amount": 15.3
            }
          ],
          "minimum": 15.3,
          "maximum": 15.8
        }
      ]
    },
    {
      "description": "NORETHINDRONE ACETATE 5 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-10747",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.35,
          "discounted_cash": 4.13,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.21
            }
          ]
        }
      ]
    },
    {
      "description": "FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-108096",
          "type": "CDM"
        },
        {
          "code": "J9395",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 367.85,
          "discounted_cash": 239.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.16
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 84.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 301.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 236.6,
              "estimated_amount": 236.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 236.6,
              "estimated_amount": 236.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 312.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 236.6,
              "estimated_amount": 236.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 301.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 202.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 268.53
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 312.67
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 239.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 232.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 275.89
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 323.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 304.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 297.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 239.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 322.6
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 202.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 236.6,
              "estimated_amount": 236.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.16
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 312.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 312.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 191.18,
              "estimated_amount": 191.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 281.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 232.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 232.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 239.47
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 367.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 100.42
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 304.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 301.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 232.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 301.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 236.6,
              "estimated_amount": 236.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 312.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 239.47
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 312.67
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 236.6,
              "estimated_amount": 236.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 312.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 322.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 232.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 236.6,
              "estimated_amount": 236.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 275.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 268.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 301.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 202.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 239.47
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 275.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 236.6,
              "estimated_amount": 236.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 312.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 268.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.16
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 301.64
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 312.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 268.53
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 268.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 236.6,
              "estimated_amount": 236.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 236.6,
              "estimated_amount": 236.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 312.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 281.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 236.6,
              "estimated_amount": 236.6
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 312.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 191.18,
              "estimated_amount": 191.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 232.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 312.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 281.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 297.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 236.6,
              "estimated_amount": 236.6
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 367.85,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 301.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 202.32
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 236.6,
              "estimated_amount": 236.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 281.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 236.6,
              "estimated_amount": 236.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 232.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 191.18,
              "estimated_amount": 191.18
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 202.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 202.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 202.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 301.64
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 281.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 281.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 312.67
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1078.5,
              "estimated_amount": 1078.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 268.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 239.47
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 367.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 367.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 191.18,
              "estimated_amount": 191.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 304.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 232.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 191.18,
              "estimated_amount": 191.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 236.6,
              "estimated_amount": 236.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 236.6,
              "estimated_amount": 236.6
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 242.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 236.6,
              "estimated_amount": 236.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 367.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 367.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 236.16
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 80.06,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 191.18,
          "maximum": 1078.5
        }
      ]
    },
    {
      "description": "PENICILLIN G BENZATHINE 600,000 UNIT/ML INTRAMUSCULAR SYRINGE",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-10897",
          "type": "CDM"
        },
        {
          "code": "J0561",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 850.65,
          "discounted_cash": 552.92,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.12
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 850.65,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 308.88,
              "estimated_amount": 308.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 697.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 553.77
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 723.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 620.97
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 850.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 723.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 649.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 723.05
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 637.99
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 649.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 308.88,
              "estimated_amount": 308.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 705.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 620.97
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 723.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 537.61
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 561.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 620.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 308.88,
              "estimated_amount": 308.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.76,
              "estimated_amount": 389.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.76,
              "estimated_amount": 389.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.76,
              "estimated_amount": 389.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 649.9
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.76,
              "estimated_amount": 389.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 649.9
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.76,
              "estimated_amount": 389.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.76,
              "estimated_amount": 389.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 850.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.76,
              "estimated_amount": 389.76
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 850.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 537.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 723.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.76,
              "estimated_amount": 389.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.76,
              "estimated_amount": 389.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 553.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 467.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 697.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 688.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 553.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 537.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 620.97
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 537.61
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 723.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 308.88,
              "estimated_amount": 308.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 697.53
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 232.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.76,
              "estimated_amount": 389.76
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 748.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.12
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 552.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 553.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 620.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 537.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 746.02
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 723.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 649.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 697.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.76,
              "estimated_amount": 389.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.76,
              "estimated_amount": 389.76
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 135.82,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 467.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 308.88,
              "estimated_amount": 308.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 697.53
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 850.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 723.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 553.77
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 850.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 723.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 697.53
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 705.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 688.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.76,
              "estimated_amount": 389.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 649.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 723.05
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 723.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 467.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 467.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 620.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 705.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 697.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 537.61
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 537.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.76,
              "estimated_amount": 389.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 546.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 537.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 723.05
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 637.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 467.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 467.86
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 723.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.76,
              "estimated_amount": 389.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 637.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 467.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 746.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.76,
              "estimated_amount": 389.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.76,
              "estimated_amount": 389.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 723.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 697.53
            }
          ],
          "minimum": 308.88,
          "maximum": 389.76
        }
      ]
    },
    {
      "description": "BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSPENSION",
      "drug_information": {
        "unit": "120",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-1090",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.35,
          "discounted_cash": 0.88,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.37
            }
          ]
        }
      ]
    },
    {
      "description": "CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "3",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-109034",
          "type": "CDM"
        },
        {
          "code": "J0706",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 53.85,
          "discounted_cash": 35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.4,
              "estimated_amount": 65.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.06
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.4,
              "estimated_amount": 65.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.4,
              "estimated_amount": 65.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.02,
              "estimated_amount": 48.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.4,
              "estimated_amount": 65.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.4,
              "estimated_amount": 65.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.4,
              "estimated_amount": 65.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.03
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.03
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.31
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 35
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.03
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.03
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.4,
              "estimated_amount": 65.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.02,
              "estimated_amount": 48.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.4,
              "estimated_amount": 65.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.16
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 35.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.39
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.31
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 47.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.4,
              "estimated_amount": 65.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.4,
              "estimated_amount": 65.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.16
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.4,
              "estimated_amount": 65.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.03
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.4,
              "estimated_amount": 65.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.4,
              "estimated_amount": 65.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.02,
              "estimated_amount": 48.02
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.4,
              "estimated_amount": 65.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.4,
              "estimated_amount": 65.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 43.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 47.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.39
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.57
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.02,
              "estimated_amount": 48.02
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 47.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.4,
              "estimated_amount": 65.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 48.02,
              "estimated_amount": 48.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.16
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 65.4,
              "estimated_amount": 65.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 43.56
            }
          ],
          "minimum": 48.02,
          "maximum": 65.4
        }
      ]
    },
    {
      "description": "LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-113060",
          "type": "CDM"
        },
        {
          "code": "J0651",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 423.4,
          "discounted_cash": 275.21,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 271.82
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 423.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 423.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 271.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 267.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 271.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 247.1,
              "estimated_amount": 247.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 351
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 359.89
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 359.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 309.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 275.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 423.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 359.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 275.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 359.89
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 359.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 271.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 232.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 347.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 347.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 267.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 342.53
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 115.59
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 372.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 271.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 371.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 267.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 371.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 271.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 271.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 323.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 267.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 267.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 347.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 351
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 351
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 359.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 323.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 309.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 359.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 309.08
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 423.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 275.21
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 279.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 232.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 271.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 267.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 309.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 342.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 271.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 247.1,
              "estimated_amount": 247.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 359.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 323.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 323.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 317.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 232.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 309.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 359.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 232.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 247.1,
              "estimated_amount": 247.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 267.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 271.82
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 359.89
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 423.4,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 359.89
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 317.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 347.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 347.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 275.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 271.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 323.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 359.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 347.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 347.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 275.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 359.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 309.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 347.19
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 423.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 323.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 247.1,
              "estimated_amount": 247.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 247.1,
              "estimated_amount": 247.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 72.1,
              "estimated_amount": 72.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 267.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 275.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 271.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 317.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 232.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 232.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 359.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 232.87
            }
          ],
          "minimum": 72.1,
          "maximum": 247.1
        }
      ]
    },
    {
      "description": "RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION",
      "drug_information": {
        "unit": "0.5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-113082",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.4,
          "discounted_cash": 6.76,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.84
            }
          ]
        }
      ]
    },
    {
      "description": "SERTRALINE 50 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-11351",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.4,
          "discounted_cash": 3.51,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.48
            }
          ]
        }
      ]
    },
    {
      "description": "SIMVASTATIN 20 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-11365",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.05,
          "discounted_cash": 3.28,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.05,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "SINCALIDE 5 MCG SOLUTION FOR INJECTION",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-11368",
          "type": "CDM"
        },
        {
          "code": "J2805",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 638.8,
          "discounted_cash": 415.22,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 488.04
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 542.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 303.59,
              "estimated_amount": 303.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 415.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 516.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 351.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 466.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 542.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 523.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 403.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 415.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 335.01,
              "estimated_amount": 335.01
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 335.01,
              "estimated_amount": 335.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 542.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 488.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 351.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 542.98
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 542.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 488.04
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.11
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 421.61
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 403.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 523.82
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 542.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 523.82
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 415.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 335.01,
              "estimated_amount": 335.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 335.01,
              "estimated_amount": 335.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 335.01,
              "estimated_amount": 335.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.11
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 542.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 466.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 560.23
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 303.59,
              "estimated_amount": 303.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 523.82
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 542.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 415.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 529.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 335.01,
              "estimated_amount": 335.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 335.01,
              "estimated_amount": 335.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 560.23
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 335.01,
              "estimated_amount": 335.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 466.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 303.59,
              "estimated_amount": 303.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 529.57
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 542.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.11
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 516.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 403.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 542.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 351.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 403.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 466.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 303.59,
              "estimated_amount": 303.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 523.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 523.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 335.01,
              "estimated_amount": 335.01
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 479.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 335.01,
              "estimated_amount": 335.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 335.01,
              "estimated_amount": 335.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 488.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 403.72
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 174.39
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 562.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 488.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 403.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 351.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 351.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 466.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 415.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 335.01,
              "estimated_amount": 335.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 335.01,
              "estimated_amount": 335.01
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.11
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 479.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 542.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 351.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 523.82
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 542.98
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 466.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 403.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 410.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 488.04
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 542.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 529.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 523.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 403.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 335.01,
              "estimated_amount": 335.01
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 351.34
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 415.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 335.01,
              "estimated_amount": 335.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 335.01,
              "estimated_amount": 335.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 335.01,
              "estimated_amount": 335.01
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 542.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 479.1
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 638.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 303.59,
              "estimated_amount": 303.59
            }
          ],
          "minimum": 303.59,
          "maximum": 335.01
        }
      ]
    },
    {
      "description": "ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "2",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-119142",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 37.35,
          "discounted_cash": 24.28,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 24.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.54
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 32.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 30.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 24.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 32.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 30.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.63
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 10.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 24.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 30.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.75
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 32.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 37.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 24.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 24.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.27
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 24.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.63
            }
          ]
        }
      ]
    },
    {
      "description": "BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION",
      "drug_information": {
        "unit": "50",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-121432",
          "type": "CDM"
        },
        {
          "code": "J0665",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 48.05,
          "discounted_cash": 31.23,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.71
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 31.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.5,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 36.04
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.84
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.5,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 39.83
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 42.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 36.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.08
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 48.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.5,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.5,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.5,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 48.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 39.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.85
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.5,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.85
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 48.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 31.23
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.5,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.5,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 42.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.5,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.84
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 38.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 48.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 39.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.5,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 48.05,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 36.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.43
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 48.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.5,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.5,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.5,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.5,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 42.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.5,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 38.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.5,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.5,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.4
            }
          ],
          "minimum": 7.5,
          "maximum": 11.7
        }
      ]
    },
    {
      "description": "SENNOSIDES 8.8 MG/5 ML ORAL SYRUP",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-121731",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.8,
          "discounted_cash": 7.02,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.95
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.74
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.18
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.88
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.03
            }
          ]
        }
      ]
    },
    {
      "description": "SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "25",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-121872",
          "type": "CDM"
        },
        {
          "code": "J3490",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 54.2,
          "discounted_cash": 35.23,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.44
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 47.53
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 43.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 47.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.07
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.07
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.28
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.65
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 35.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 47.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.65
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 43.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 35.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.44
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.25
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.25
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.07
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.07
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 14.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 54.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.07
            }
          ]
        }
      ]
    },
    {
      "description": "DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION",
      "drug_information": {
        "unit": "2.5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-12211",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 399.2,
          "discounted_cash": 259.48,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 252.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 299.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 221.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 250.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 219.56
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 339.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 252.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 250.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 304.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 219.56
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 339.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 252.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 299.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 219.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 259.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 339.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 252.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 252.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 322.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 291.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 259.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 250.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 252.29
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 351.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 304.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 221.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 330.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 250.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 291.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 327.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 327.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 339.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.29
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 299.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 291.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 339.32
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 339.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 259.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 259.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 221.56
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 339.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 250.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 219.56
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 263.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 304.99
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 399.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 327.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 327.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 339.32
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 339.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 304.99
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 108.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 250.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 252.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 221.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 327.34
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 339.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 350.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 252.29
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 259.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 291.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 322.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 250.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 250.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 330.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 219.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 291.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 330.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 339.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 250.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 399.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 304.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 350.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 339.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 327.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 304.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 259.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 327.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 250.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 250.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 291.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 256.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 219.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 219.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 250.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 250.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 327.34
            }
          ]
        }
      ]
    },
    {
      "description": "LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK",
      "drug_information": {
        "unit": "300",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-124737",
          "type": "CDM"
        },
        {
          "code": "J2020",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 90.2,
          "discounted_cash": 58.63,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 68.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.01
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 57.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.41,
              "estimated_amount": 25.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.67
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 58.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 72.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.61
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 57.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.41,
              "estimated_amount": 25.41
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 57.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.61
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 57.91
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 57.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.67
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.41,
              "estimated_amount": 25.41
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 59.53
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.96
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 57.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 68.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 67.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 68.91
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 67.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.41,
              "estimated_amount": 25.41
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 79.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.41,
              "estimated_amount": 25.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 74.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 58.72
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 79.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 79.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 74.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.67
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 58.72
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 72.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 74.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.96
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 67.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 57.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 57.91
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 58.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 57.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 68.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.67
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 68.91
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.96
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.61
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 24.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.01
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 58.72
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 25.05,
              "estimated_amount": 25.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 68.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 57.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.01
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 90.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 57.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 57.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.96
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 76.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 58.72
            }
          ],
          "minimum": 25.05,
          "maximum": 25.41
        }
      ]
    },
    {
      "description": "CAFFEINE 200 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-1259",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.05,
          "discounted_cash": 0.03,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "SEORMC [545]",
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              "standard_charge_percentage": 66,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            }
          ]
        }
      ]
    },
    {
      "description": "ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION",
      "drug_information": {
        "unit": "0.5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-127257",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.05,
          "discounted_cash": 3.93,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "COFINITY [407]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.05
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            }
          ]
        }
      ]
    },
    {
      "description": "DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK",
      "drug_information": {
        "unit": "100",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-128040",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 70.5,
          "discounted_cash": 45.82,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.81
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 70.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 46.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 45.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 45.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.93
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 19.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 70.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 58.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 39.13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 45.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 45.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.81
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.56
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.27
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 57.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 58.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 59.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 52.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 59.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 39.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
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              "standard_charge_percentage": 82.9,
              "estimated_amount": 58.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 62.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 51.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 61.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 57.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
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              "standard_charge_percentage": 87.7,
              "estimated_amount": 61.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.27
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.27
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.27
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
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              "standard_charge_percentage": 65,
              "estimated_amount": 45.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.81
            },
            {
              "payer_name": "FLORA [411]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 59.93
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.86
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 51.47
            },
            {
              "payer_name": "ANTHEM [335]",
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              "standard_charge_percentage": 55.5,
              "estimated_amount": 39.13
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 51.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 39.13
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
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              "standard_charge_percentage": 75,
              "estimated_amount": 52.88
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
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              "standard_charge_percentage": 75,
              "estimated_amount": 52.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 38.78
            }
          ]
        }
      ]
    },
    {
      "description": "ANTI-INHIBITOR COAGULANT COMPLX 1,750 UNIT-3,250 UNIT INTRAVENOUS SOLN",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-128157",
          "type": "CDM"
        },
        {
          "code": "J7198",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 19707.6,
          "discounted_cash": 12809.94,
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              "payer_name": "AETNA [310]",
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              "estimated_amount": 15056.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 16751.46
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
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              "standard_charge_percentage": 88,
              "estimated_amount": 17342.69
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 12829.65
            },
            {
              "payer_name": "COVENTRY [406]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 16751.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 10839.18
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 87.7,
              "estimated_amount": 17283.57
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 12652.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 12455.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16000,
              "estimated_amount": 16000
            },
            {
              "payer_name": "FLORA [411]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 16751.46
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
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              "standard_charge_percentage": 27.3,
              "estimated_amount": 5380.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 10839.18
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 12809.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 12829.65
            },
            {
              "payer_name": "UHC [625]",
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              "estimated_amount": 16000
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_dollar": 16000,
              "estimated_amount": 16000
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16000,
              "estimated_amount": 16000
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 16751.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 16160.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
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              "standard_charge_dollar": 16000,
              "estimated_amount": 16000
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
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              "standard_charge_percentage": 75,
              "estimated_amount": 14780.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16000,
              "estimated_amount": 16000
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12652.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15056.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 15943.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16000,
              "estimated_amount": 16000
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10839.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12455.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13396.5,
              "estimated_amount": 13396.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16160.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16000,
              "estimated_amount": 16000
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13396.5,
              "estimated_amount": 13396.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13396.5,
              "estimated_amount": 13396.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16000,
              "estimated_amount": 16000
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16751.46
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14780.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10839.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14386.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16751.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16337.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12652.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15056.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12455.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13396.5,
              "estimated_amount": 13396.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16160.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16160.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12455.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14386.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12829.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16000,
              "estimated_amount": 16000
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12652.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12652.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12652.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16160.23
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16751.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12652.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16000,
              "estimated_amount": 16000
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16751.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14386.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16337.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16000,
              "estimated_amount": 16000
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12652.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12652.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10839.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16160.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12652.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12455.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 17283.57
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16751.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14386.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14386.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12829.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14780.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16751.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12455.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15056.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13396.5,
              "estimated_amount": 13396.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12652.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15056.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12455.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16160.23
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16751.46
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 13007.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10839.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16337.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16000,
              "estimated_amount": 16000
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16000,
              "estimated_amount": 16000
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16000,
              "estimated_amount": 16000
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10839.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16751.46
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 19707.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 15943.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12829.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12652.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15056.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12455.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16160.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16000,
              "estimated_amount": 16000
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16000,
              "estimated_amount": 16000
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14386.55
            }
          ],
          "minimum": 13396.5,
          "maximum": 16000
        }
      ]
    },
    {
      "description": "BUPIVACAINE 0.5 %-EPINEPHRINE BITARTRATE 1:200,000 INJECTION,CARTRIDGE",
      "drug_information": {
        "unit": "1.8",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-128232",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 38.15,
          "discounted_cash": 24.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 24.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 24.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 24.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 33.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.84
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 21.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.63
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 21.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 33.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 24.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 21.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 24.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 21.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 25.18
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 38.15
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 33.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.98
            }
          ]
        }
      ]
    },
    {
      "description": "HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML INTRAMUSCULAR SYRINGE",
      "drug_information": {
        "unit": ".5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-128663",
          "type": "CDM"
        },
        {
          "code": "90371",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 418.2,
          "discounted_cash": 271.83,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 268.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 268.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 313.65
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 342.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.62,
              "estimated_amount": 389.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 272.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 366.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.62,
              "estimated_amount": 389.62
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 271.83
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 418.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 272.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 230.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 342.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 272.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 418.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.62,
              "estimated_amount": 389.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.62,
              "estimated_amount": 389.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 319.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 305.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 342.92
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.62,
              "estimated_amount": 389.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.62,
              "estimated_amount": 389.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 305.29
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 272.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.62,
              "estimated_amount": 389.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 264.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 313.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 230.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 230.01
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 319.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 264.3
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 145.21,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 305.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 330.22,
              "estimated_amount": 330.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 346.69
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 418.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 268.48
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.62,
              "estimated_amount": 389.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.62,
              "estimated_amount": 389.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 230.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 305.29
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.62,
              "estimated_amount": 389.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.62,
              "estimated_amount": 389.62
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 319.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 268.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 272.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 330.22,
              "estimated_amount": 330.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 264.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 264.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 230.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 230.01
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 268.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 268.48
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 305.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 330.22,
              "estimated_amount": 330.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 342.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.62,
              "estimated_amount": 389.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 268.48
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 268.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 338.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.62,
              "estimated_amount": 389.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 330.22,
              "estimated_amount": 330.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 342.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 338.32
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 330.22,
              "estimated_amount": 330.22
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 418.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 268.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 268.48
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 268.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 305.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 346.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 319.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 368.02
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 313.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 346.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 342.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.62,
              "estimated_amount": 389.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.62,
              "estimated_amount": 389.62
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 264.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 264.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 418.2,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.62,
              "estimated_amount": 389.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 319.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 366.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 418.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 264.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 264.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 342.92
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 114.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 268.48
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 138.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 276.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 230.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 389.62,
              "estimated_amount": 389.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 342.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 319.5
            }
          ],
          "minimum": 330.22,
          "maximum": 389.62
        }
      ]
    },
    {
      "description": "FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-129448",
          "type": "CDM"
        },
        {
          "code": "J3490",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 34.2,
          "discounted_cash": 22.23,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.83,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 27.67
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.61
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 30.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.65
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.61
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.61
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.04
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 29.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.83,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.83,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.83,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.61
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 27.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.97
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 29.99
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.04
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 22.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.97
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 22.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.83,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.2,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.07
            }
          ],
          "minimum": 1.83,
          "maximum": 1.83
        }
      ]
    },
    {
      "description": "LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLUTION",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-130190",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 12.2,
          "discounted_cash": 7.93,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.94
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.91
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.37
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 10.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.15
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.37
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 8.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 12.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.37
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.77
            }
          ]
        }
      ]
    },
    {
      "description": "LIDOCAINE (PF) 100 MG/5 ML (2 %) INJECTION SYRINGE",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-131861",
          "type": "CDM"
        },
        {
          "code": "J7999",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 58.1,
          "discounted_cash": 37.76,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 44.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 50.95
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.39
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.3
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 42.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 43.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.82
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 42.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.64
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 42.41
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 42.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 48.16
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 48.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.64
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 44.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.3
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 44.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.72
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 48.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.72
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.39
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.39
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 42.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 58.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 44.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 32.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 44.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 44.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.72
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.39
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 38.35
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 37.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 32.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 51.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 42.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 15.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 32.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 50.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 49.39
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 43.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 32.25
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 37.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 43.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 47.64
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 58.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "MORPHINE (PF) 2 MG/2 ML(1 MG/ML) IN 0.9% SODIUM CHLORIDE IV SYRINGE",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-132075",
          "type": "CDM"
        },
        {
          "code": "J2270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 46.8,
          "discounted_cash": 30.42,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.74
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 30.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 38.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.44,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 35.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.58
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.16
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 37.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.76
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.38
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 41.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.44,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 37.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.47
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 30.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.47
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.38
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 41.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.38
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 38.8
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 12.78
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.44,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 38.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.58
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.74
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 35.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.44,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 46.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.44,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 35.1
            }
          ],
          "minimum": 10.44,
          "maximum": 13.12
        }
      ]
    },
    {
      "description": "LOSARTAN 50 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-14824",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.4,
          "discounted_cash": 3.51,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.47
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.94
            }
          ]
        }
      ]
    },
    {
      "description": "SOTALOL 120 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-15723",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5,
          "discounted_cash": 3.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            }
          ]
        }
      ]
    },
    {
      "description": "ACARBOSE 50 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-15895",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.6,
          "discounted_cash": 3.64,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            }
          ]
        }
      ]
    },
    {
      "description": "CEFEPIME 2 GRAM SOLUTION FOR INJECTION",
      "drug_information": {
        "unit": "2000",
        "type": "ME"
      },
      "code_information": [
        {
          "code": "RX-16371",
          "type": "CDM"
        },
        {
          "code": "J0692",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 54.9,
          "discounted_cash": 35.68,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.24,
              "estimated_amount": 13.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.24,
              "estimated_amount": 13.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.24,
              "estimated_amount": 13.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.24,
              "estimated_amount": 13.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.24,
              "estimated_amount": 13.24
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.67
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.54,
              "estimated_amount": 12.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.74
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.2
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 14.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.25
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.24,
              "estimated_amount": 13.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 45.51
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.54,
              "estimated_amount": 12.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.25
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.67
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 44.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.02
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 48.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.24,
              "estimated_amount": 13.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.24,
              "estimated_amount": 13.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.94
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.24,
              "estimated_amount": 13.24
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 36.23
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.24,
              "estimated_amount": 13.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.67
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.02
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.24,
              "estimated_amount": 13.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 48.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.24,
              "estimated_amount": 13.24
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.24,
              "estimated_amount": 13.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.54,
              "estimated_amount": 12.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.02
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 35.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.24,
              "estimated_amount": 13.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 45.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.02
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 45.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.54,
              "estimated_amount": 12.54
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.24,
              "estimated_amount": 13.24
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 44.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.24,
              "estimated_amount": 13.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.24,
              "estimated_amount": 13.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.54,
              "estimated_amount": 12.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.2
            }
          ],
          "minimum": 12.54,
          "maximum": 13.24
        }
      ]
    },
    {
      "description": "WHITE PETROLATUM 42 % TOPICAL OINTMENT",
      "drug_information": {
        "unit": "100",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-167070",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.3,
          "discounted_cash": 2.79,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.37
            }
          ]
        }
      ]
    },
    {
      "description": "HUM PROTHROMBIN CPLX (PCC) 4FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION",
      "drug_information": {
        "unit": "500",
        "type": "F2"
      },
      "code_information": [
        {
          "code": "RX-169186",
          "type": "CDM"
        },
        {
          "code": "J7168",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4286.35,
          "discounted_cash": 2786.13,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2751.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3274.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2357.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3553.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3514.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3514.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2790.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3075,
              "estimated_amount": 3075
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3075,
              "estimated_amount": 3075
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2751.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3486.6,
              "estimated_amount": 3486.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3274.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2708.97
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3643.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2357.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3486.6,
              "estimated_amount": 3486.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3075,
              "estimated_amount": 3075
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2708.97
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3643.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3514.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2790.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3075,
              "estimated_amount": 3075
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3486.6,
              "estimated_amount": 3486.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3514.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3514.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2708.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3075,
              "estimated_amount": 3075
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3129.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3514.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3514.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2751.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3075,
              "estimated_amount": 3075
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2357.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3075,
              "estimated_amount": 3075
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3643.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3075,
              "estimated_amount": 3075
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3075,
              "estimated_amount": 3075
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3075,
              "estimated_amount": 3075
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3214.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2357.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2357.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3075,
              "estimated_amount": 3075
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2786.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3643.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3129.04
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 3771.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3486.6,
              "estimated_amount": 3486.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3129.04
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3643.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2790.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2708.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2751.84
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2828.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3075,
              "estimated_amount": 3075
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3643.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3075,
              "estimated_amount": 3075
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2751.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2357.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2790.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3274.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2708.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2357.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3075,
              "estimated_amount": 3075
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3643.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2751.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3274.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2751.84
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3214.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3553.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3274.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3214.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3467.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2751.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3274.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2708.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3759.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2708.97
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3643.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3643.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3129.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3486.6,
              "estimated_amount": 3486.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3643.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2790.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3467.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3075,
              "estimated_amount": 3075
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3075,
              "estimated_amount": 3075
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4286.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3553.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3129.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3075,
              "estimated_amount": 3075
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2751.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2751.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3759.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3643.4
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3643.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3514.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2751.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2708.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3129.04
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1170.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2751.84
            }
          ],
          "minimum": 3075,
          "maximum": 3486.6
        }
      ]
    },
    {
      "description": "GEMCITABINE 1 GRAM INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "26.3",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-17122",
          "type": "CDM"
        },
        {
          "code": "J9201",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 143.3,
          "discounted_cash": 93.14,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 90.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.8,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 42.71,
              "estimated_amount": 42.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.8,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 109.48
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 165.35,
              "estimated_amount": 165.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.8,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 125.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 104.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 42.71,
              "estimated_amount": 42.71
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 121.81
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 94.58
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 90.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 90.57
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 121.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 93.29
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 121.81
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 121.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 115.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 93.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 90.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 42.71,
              "estimated_amount": 42.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 104.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 115.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 109.48
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 117.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 90.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 125.67
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 117.51
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 104.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.8,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 104.61
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 126.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 93.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 109.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 93.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 42.71,
              "estimated_amount": 42.71
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 39.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 93.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.8,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.8,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 104.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 109.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 117.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 92
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 117.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.8,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 118.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 117.51
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.8,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 121.81
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 121.81
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 121.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.8,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.8,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 121.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.82
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 109.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 90.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.8,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 90.57
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 121.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 121.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 42.71,
              "estimated_amount": 42.71
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.8,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 118.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 117.51
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 107.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.8,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 121.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 109.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 92
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 107.48
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.8,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 107.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 104.61
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 117.51
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.82
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 143.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.8,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.8,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.8,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 90.57
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 121.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 118.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 92
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 93.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 121.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 117.51
            }
          ],
          "minimum": 37.8,
          "maximum": 165.35
        }
      ]
    },
    {
      "description": "EDOXABAN 30 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-171997",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 46.4,
          "discounted_cash": 30.16,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 40.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.05
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.44
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 37.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 25.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 25.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 38.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.21
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 30.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.87
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 30.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 25.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 40.83
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 46.4
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 12.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 30.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 46.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 25.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 30.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 30.11
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 30.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 38.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 37.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 40.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 38.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.87
            }
          ]
        }
      ]
    },
    {
      "description": "CARBIDOPA ER 48.75 MG-LEVODOPA 195 MG CAPSULE,EXTENDED RELEASE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-172037",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 16.65,
          "discounted_cash": 10.82,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.69
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.15
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.69
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 10.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 10.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 10.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 16.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.46
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.8
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 14.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 10.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 10.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 10.82
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.69
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 16.65,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "IVABRADINE 5 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-172896",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 33.35,
          "discounted_cash": 21.68,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.41
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 18.51
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 33.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 26.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.08
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 27.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 18.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.08
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.94
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 29.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 18.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 29.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 18.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 29.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.35
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 21.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 26.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 21.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 33.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.41
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 22.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.94
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 27.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 27.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.41
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 20.94
            },
            {
              "payer_name": "AETNA [310]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.35
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.35
            }
          ]
        }
      ]
    },
    {
      "description": "GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION",
      "drug_information": {
        "unit": "0.5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-173114",
          "type": "CDM"
        },
        {
          "code": "J1611",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 319.4,
          "discounted_cash": 207.61,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.05
            },
            {
              "payer_name": "AETNA [310]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 244.02
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 281.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 261.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
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              "standard_charge_dollar": 351.41,
              "estimated_amount": 351.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 351.41,
              "estimated_amount": 351.41
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 207.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 351.41,
              "estimated_amount": 351.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 351.41,
              "estimated_amount": 351.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 261.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 201.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 175.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 258.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 207.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 207.93
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 351.41,
              "estimated_amount": 351.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 261.91
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 239.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 175.67
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 319.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 351.41,
              "estimated_amount": 351.41
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 319.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 244.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 351.41,
              "estimated_amount": 351.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 244.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 201.86
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 239.55
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.05
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 210.8
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 319.4,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 301.58,
              "estimated_amount": 301.58
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 87.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 244.02
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 351.41,
              "estimated_amount": 351.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.49
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 233.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 301.58,
              "estimated_amount": 301.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 201.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 175.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 175.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 264.78
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 319.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 264.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 351.41,
              "estimated_amount": 351.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 233.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 351.41,
              "estimated_amount": 351.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 351.41,
              "estimated_amount": 351.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 201.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 351.41,
              "estimated_amount": 351.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 207.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 201.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 201.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 175.67
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 201.86
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 258.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 175.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 261.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 233.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 244.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 207.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 351.41,
              "estimated_amount": 351.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 261.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 207.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 351.41,
              "estimated_amount": 351.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 351.41,
              "estimated_amount": 351.41
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 319.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 233.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 280.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 351.41,
              "estimated_amount": 351.41
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 319.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 301.58,
              "estimated_amount": 301.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 301.58,
              "estimated_amount": 301.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 264.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 261.91
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 239.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 244.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 233.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 261.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 261.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 280.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 175.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 301.58,
              "estimated_amount": 301.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 351.41,
              "estimated_amount": 351.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 201.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 233.16
            }
          ],
          "minimum": 301.58,
          "maximum": 351.41
        }
      ]
    },
    {
      "description": "SACUBITRIL 97 MG-VALSARTAN 103 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-173927",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 37.45,
          "discounted_cash": 24.34,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.52
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 10.22
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 24.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.78
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 32.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 32.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 37.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.38
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 32.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 24.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 24.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.05
            }
          ]
        }
      ]
    },
    {
      "description": "BUSPIRONE 15 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-17464",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.7,
          "discounted_cash": 3.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            }
          ]
        }
      ]
    },
    {
      "description": "MIRTAZAPINE 15 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-17466",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.05,
          "discounted_cash": 3.28,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.8
            }
          ]
        }
      ]
    },
    {
      "description": "MORPHINE 4 MG/ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-175213",
          "type": "CDM"
        },
        {
          "code": "J2270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 43.9,
          "discounted_cash": 28.53,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.44,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.32
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.58
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.32
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.74
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 28.54
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.32
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 35.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.44,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.93
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.44,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 38.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.74
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.32
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 38.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 35.52
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.39
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.44,
              "estimated_amount": 10.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.05
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.12,
              "estimated_amount": 13.12
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.58
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 11.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.18
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 28.97
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.74
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.32
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.39
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 38.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.44,
              "estimated_amount": 10.44
            }
          ],
          "minimum": 10.44,
          "maximum": 13.12
        }
      ]
    },
    {
      "description": "OXYCODONE ER 36 MG CAPSULE SPRINKLE EXTENDED RELEASE 12HR(DON'T CRUSH)",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-178178",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 63.55,
          "discounted_cash": 41.31,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.66
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.24
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.91
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.91
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.66
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.37
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 41.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 63.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.27
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 55.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.91
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.73
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 41.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.95
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.02
            }
          ]
        }
      ]
    },
    {
      "description": "VANCOMYCIN 750 MG/150 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK",
      "drug_information": {
        "unit": "150",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-178243",
          "type": "CDM"
        },
        {
          "code": "J3370",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 90.85,
          "discounted_cash": 59.05,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.41
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.07,
              "estimated_amount": 12.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.42
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 68.14
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.07,
              "estimated_amount": 12.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 79.68
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.07,
              "estimated_amount": 12.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 75.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.07,
              "estimated_amount": 12.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12.07,
              "estimated_amount": 12.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.33
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 68.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.22
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.42
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.5
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 73.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.22
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 68.14
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 73.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.42
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.97
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 75.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.42
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.33
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 24.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 79.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 75.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.33
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 59.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.5
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 59.05
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 79.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 49.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.33
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 90.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.7,
              "estimated_amount": 11.7
            }
          ],
          "minimum": 11.7,
          "maximum": 12.07
        }
      ]
    },
    {
      "description": "SODIUM POLYSTYRENE SULFONATE 15 GRAM-SORBITOL 20 GRAM/60 ML ORAL SUSP",
      "drug_information": {
        "unit": "60",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-179041",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 101.15,
          "discounted_cash": 65.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 83.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.52
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 81.83
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 101.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 56.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 101.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 83.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 65.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 75.86
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 75.86
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 65.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 65.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 56.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 56.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 65.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.98
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 56.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73.84
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 27.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 65.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 65.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 89.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 88.71
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.98
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 88.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 65.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 65.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 65.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 65.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 83.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 77.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.93
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 75.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73.84
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 66.76
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.98
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 81.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 82.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 85.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 63.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 63.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 73.84
            }
          ]
        }
      ]
    },
    {
      "description": "ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION",
      "drug_information": {
        "unit": "20",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-18192",
          "type": "CDM"
        },
        {
          "code": "J2795",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 63.35,
          "discounted_cash": 41.18,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.56
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.4,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.4,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.85
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.04
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 41.81
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 55.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.85
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.4,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.84
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.4,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.4,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.85
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.4,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.4,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.55,
              "estimated_amount": 6.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.51
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.4,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.4,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.4,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.55,
              "estimated_amount": 6.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.52
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.4,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.4,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.55,
              "estimated_amount": 6.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.55,
              "estimated_amount": 6.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.4,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.29
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.67
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.4,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.51
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.4
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.4,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.4,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.55,
              "estimated_amount": 6.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.52
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.24
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.04
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.4,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.25
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.4
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.51
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 63.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.95
            }
          ],
          "minimum": 6.4,
          "maximum": 6.55
        }
      ]
    },
    {
      "description": "MEROPENEM-VABORBACTAM 2 GRAM INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "21",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-183156",
          "type": "CDM"
        },
        {
          "code": "J2186",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1110.7,
          "discounted_cash": 721.95,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 713.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 713.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 610.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 505.44,
              "estimated_amount": 505.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 898.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 505.44,
              "estimated_amount": 505.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 910.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 713.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 974.08
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 944.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 701.96
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 303.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 713.07
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 944.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 610.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 810.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 505.44,
              "estimated_amount": 505.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 920.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 564,
              "estimated_amount": 564
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 920.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 848.57
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 944.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 701.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 701.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 944.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 723.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 564,
              "estimated_amount": 564
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 944.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 810.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 910.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 910.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 564,
              "estimated_amount": 564
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 723.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 564,
              "estimated_amount": 564
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 810.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 713.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 701.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 564,
              "estimated_amount": 564
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 564,
              "estimated_amount": 564
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 564,
              "estimated_amount": 564
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 505.44,
              "estimated_amount": 505.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 723.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 610.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 505.44,
              "estimated_amount": 505.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 910.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 910.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 701.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 944.1
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1110.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 721.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 713.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 848.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 713.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 564,
              "estimated_amount": 564
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 713.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 898.56
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 944.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 810.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 723.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 833.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 564,
              "estimated_amount": 564
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 833.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 944.1
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 733.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 610.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 610.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 713.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 564,
              "estimated_amount": 564
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 944.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 944.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 810.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 910.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 910.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 610.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 723.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 564,
              "estimated_amount": 564
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 564,
              "estimated_amount": 564
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 713.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 701.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 564,
              "estimated_amount": 564
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 848.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 974.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 564,
              "estimated_amount": 564
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 713.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 848.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 833.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 564,
              "estimated_amount": 564
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 944.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 701.96
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 944.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 610.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 810.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 920.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 564,
              "estimated_amount": 564
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 701.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 564,
              "estimated_amount": 564
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 848.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 848.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 713.07
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 977.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 910.77
            }
          ],
          "minimum": 505.44,
          "maximum": 564
        }
      ]
    },
    {
      "description": "ROPIV 2.46-EPI 0.005-CLONID 0.0008-KETOROL 0.3 MG/ML PERIARTICULR SYRG",
      "drug_information": {
        "unit": "50",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-184048",
          "type": "CDM"
        },
        {
          "code": "J7999",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 252.65,
          "discounted_cash": 164.22,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 221.57
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 164.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 184.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 214.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 159.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 159.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 138.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 193.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 214.75
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 214.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 138.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 140.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 140.22
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 214.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 193.02
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 214.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 189.49
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 138.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 184.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 207.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 164.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 164.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 138.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 193.02
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 140.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 159.67
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 214.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 209.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 207.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 214.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 204.39
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 166.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 159.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 184.43
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 189.49
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 214.75
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 138.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 184.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 164.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 214.75
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 214.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 207.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 193.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 221.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 140.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 207.17
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 222.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 184.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 209.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 252.65
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.2
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 68.97
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 214.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 159.67
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 159.67
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 214.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 159.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 204.39
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 159.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 214.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 207.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 207.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 209.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 207.17
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 193.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 164.22
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 214.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 193.02
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 189.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 162.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 138.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 184.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 164.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 252.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 207.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 138.96
            }
          ]
        }
      ]
    },
    {
      "description": "VASOPRESSIN 20 UNIT/100 ML (0.2 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV",
      "drug_information": {
        "unit": "100",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-186925",
          "type": "CDM"
        },
        {
          "code": "J2601",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 317.2,
          "discounted_cash": 206.18,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 203.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 231.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 242.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 200.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 260.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 269.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 203.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 242.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 203.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 260.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 174.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 203.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 206.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 260.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 203.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 242.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 278.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 237.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 206.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 174.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 269.62
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 269.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 174.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 200.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 262.96
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 269.62
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 269.62
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 269.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 206.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 260.1
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 86.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 260.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 237.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 278.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 174.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 203.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 200.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 203.64
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 269.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 262.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 260.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 206.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 174.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 262.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 200.47
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 206.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 231.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 203.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 231.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 256.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 203.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 203.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 242.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 269.62
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 279.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 200.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 269.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 174.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 260.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 256.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 174.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 200.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 231.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 203.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 231.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 206.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 200.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 200.47
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 209.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 317.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 269.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 269.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 203.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 242.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 242.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 260.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 237.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 231.56
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 269.62
            }
          ]
        }
      ]
    },
    {
      "description": "TRASTUZUMAB-DTTB 150 MG INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "7.1415",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-190818",
          "type": "CDM"
        },
        {
          "code": "Q5112",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2437.65,
          "discounted_cash": 1584.47,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1862.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1340.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2020.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1998.87
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1586.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1319.55,
              "estimated_amount": 1319.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1540.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1540.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1779.48
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1586.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1319.55,
              "estimated_amount": 1319.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1319.55,
              "estimated_amount": 1319.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2020.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1319.55,
              "estimated_amount": 1319.55
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2137.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1779.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1195.51,
              "estimated_amount": 1195.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1998.87
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2072
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2437.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1340.71
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2145.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1319.55,
              "estimated_amount": 1319.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2020.81
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1319.55,
              "estimated_amount": 1319.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1564.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1564.97
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1828.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1564.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1564.97
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1319.55,
              "estimated_amount": 1319.55
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2437.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1862.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1540.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2137.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2072
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1998.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1998.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1862.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1862.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2072
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1779.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1195.51,
              "estimated_amount": 1195.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1564.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1564.97
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 533.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1319.55,
              "estimated_amount": 1319.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2437.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2072
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1586.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1340.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1340.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1340.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1340.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1972.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1972.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1319.55,
              "estimated_amount": 1319.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1319.55,
              "estimated_amount": 1319.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1319.55,
              "estimated_amount": 1319.55
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2072
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1998.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1564.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1540.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2072
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1319.55,
              "estimated_amount": 1319.55
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1584.47
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2072
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2072
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1586.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1319.55,
              "estimated_amount": 1319.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1862.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1779.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1779.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1195.51,
              "estimated_amount": 1195.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2072
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1608.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2437.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1862.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1828.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1564.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1564.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1540.59
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1319.55,
              "estimated_amount": 1319.55
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1340.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1998.87
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2072
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2072
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1564.97
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 525.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1828.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1586.91
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 665.48
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1540.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1779.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1998.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1319.55,
              "estimated_amount": 1319.55
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2437.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1195.51,
              "estimated_amount": 1195.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1998.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1319.55,
              "estimated_amount": 1319.55
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2072
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1319.55,
              "estimated_amount": 1319.55
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2072
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1564.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1540.59
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1195.51,
              "estimated_amount": 1195.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1564.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1540.59
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2072
            }
          ],
          "minimum": 1195.51,
          "maximum": 1319.55
        }
      ]
    },
    {
      "description": "MIDAZOLAM (PF) 1 MG/ML IN SODIUM CHLORIDE,ISO-OSM INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "100",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-191727",
          "type": "CDM"
        },
        {
          "code": "J7999",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 150.95,
          "discounted_cash": 98.12,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 96.91
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 98.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 83.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 125.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 123.78
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 115.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 110.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 115.33
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 113.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 122.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.02
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.02
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 96.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 123.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 123.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.31
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 110.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 83.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 115.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.4
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 123.78
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 132.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 96.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 96.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 132.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 83.78
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.02
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 123.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 123.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 113.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 96.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 96.91
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 98.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.4
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 123.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 98.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 132.38
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 125.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 123.78
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 125.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 122.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 96.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 96.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 115.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 110.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 96.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 110.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 150.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 83.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 113.21
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 110.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 96.91
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.31
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 98.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 98.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.02
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 41.21
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 115.33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 110.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 98.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 96.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 96.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 115.33
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 99.63
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.31
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 150.95,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "INSULIN REGULAR HUMAN U-500(CONCENTRATE) 500 UNIT/ML SUBCUTANEOUS SOLN",
      "drug_information": {
        "unit": "20",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-19180",
          "type": "CDM"
        },
        {
          "code": "J1815",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6869.3,
          "discounted_cash": 4465.04,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4410.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6024.38
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5838.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5014.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5632.83
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5838.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5632.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4341.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5248.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5248.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5557.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5151.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4410.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4410.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4341.4
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5838.91
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5838.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5632.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4471.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5838.91
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4471.91
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5632.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5632.83
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5248.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4410.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5838.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3778.12
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5838.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4471.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5694.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4465.05
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5838.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4341.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4341.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4341.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5694.65
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1875.32
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5838.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5248.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5014.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5014.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5838.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5632.83
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5151.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5694.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5838.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4341.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3812.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5151.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4410.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6024.38
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5838.91
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1504.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4410.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5014.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1236.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3778.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5014.59
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5838.91
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5632.83
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4410.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4410.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4341.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1236.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3778.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3778.12
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4410.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4341.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3812.46
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5557.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6869.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3778.12
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6044.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4471.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4471.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5248.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3778.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5248.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4410.09
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5838.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5014.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5632.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3812.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3812.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4410.09
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4533.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4410.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3778.12
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6869.3,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "METHACHOLINE CHLORIDE 0 MG/3 ML (0 MG/ML) NEBULIZATION SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-192080",
          "type": "CDM"
        },
        {
          "code": "J7999",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 75.25,
          "discounted_cash": 48.91,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 75.25
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 41.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.71
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 65.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.93
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 49.67
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.38
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 60.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 41.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.71
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.99
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 66.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 65.99
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.71
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 60.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.39
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 20.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.39
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.49
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 41.76
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.56
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 48.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 41.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.96
            }
          ]
        }
      ]
    },
    {
      "description": "CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",
      "drug_information": {
        "unit": "1.5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-19333",
          "type": "CDM"
        },
        {
          "code": "J0735",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 42.85,
          "discounted_cash": 27.85,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.83,
              "estimated_amount": 39.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 37.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 35.52
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.14
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.83,
              "estimated_amount": 39.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.83,
              "estimated_amount": 39.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 35.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.42
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.83,
              "estimated_amount": 39.83
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 28.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 37.58
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.42
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.42
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.83,
              "estimated_amount": 39.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.57
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 37.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.42
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.74
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 35.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.51
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 42.85,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 39.83,
          "maximum": 49.78
        }
      ]
    },
    {
      "description": "CEFDINIR 300 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-22289",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.65,
          "discounted_cash": 4.32,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            }
          ]
        }
      ]
    },
    {
      "description": "KETOROLAC 15 MG/ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-22472",
          "type": "CDM"
        },
        {
          "code": "J1885",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 36.05,
          "discounted_cash": 23.43,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.78
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 31.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.04
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.64,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.64,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.83
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.04,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.64,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.64,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.32
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 23.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 23.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.78
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.78
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.64,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.83
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.32
            }
          ],
          "minimum": 1.04,
          "maximum": 1.84
        }
      ]
    },
    {
      "description": "SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-22560",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 12.25,
          "discounted_cash": 7.96,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 10.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.36
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 12.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.16
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 8.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.74
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 7.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.05
            }
          ]
        }
      ]
    },
    {
      "description": "DICLOXACILLIN 250 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-2414",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.25,
          "discounted_cash": 4.06,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.95
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.95
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.07
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.13
            }
          ]
        }
      ]
    },
    {
      "description": "HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) IN DEXTROSE 5 % IV",
      "drug_information": {
        "unit": "250",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-24329",
          "type": "CDM"
        },
        {
          "code": "J1644",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 96.5,
          "discounted_cash": 62.72,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 70.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 80
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 78.07
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 72.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 73.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.99
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15,
              "estimated_amount": 15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15,
              "estimated_amount": 15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.08
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 72.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15,
              "estimated_amount": 15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 73.73
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 79.13
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 79.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 63.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15,
              "estimated_amount": 15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15,
              "estimated_amount": 15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 73.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 70.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 80
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 84.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15,
              "estimated_amount": 15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 72.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15,
              "estimated_amount": 15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 70.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 79.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 70.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 79.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15,
              "estimated_amount": 15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 79.13
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15,
              "estimated_amount": 15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.08
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 70.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 79.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15,
              "estimated_amount": 15
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 26.34
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15,
              "estimated_amount": 15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15,
              "estimated_amount": 15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.08
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15,
              "estimated_amount": 15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 73.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 84.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15,
              "estimated_amount": 15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 80
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 73.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.99
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 78.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15,
              "estimated_amount": 15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 79.13
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 73.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15,
              "estimated_amount": 15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 79.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.8,
              "estimated_amount": 15.8
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 84.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.99
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 70.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15,
              "estimated_amount": 15
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 62.73
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 96.5,
              "additional_payer_notes": "OUTPATIENT"
            }
          ],
          "minimum": 15,
          "maximum": 15.8
        }
      ]
    },
    {
      "description": "TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-24914",
          "type": "CDM"
        },
        {
          "code": "J7507",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 15.55,
          "discounted_cash": 10.11,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.88
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.22
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 13.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12.58
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.98
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.22
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.89
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.75
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 15.55
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 13.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 10.26
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.22
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.66
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.12
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.22
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.83
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 13.64
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.12
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.98
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.35
            }
          ]
        }
      ]
    },
    {
      "description": "VERAPAMIL ER 120 MG 24 HR CAPSULE,EXTENDED RELEASE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-25238",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 15.95,
          "discounted_cash": 10.37,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 10.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 13.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 10.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.08
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.22
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.96
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 10.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.22
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.08
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 13.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 10.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 10.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.24
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 14.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.96
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 10.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 10.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.08
            }
          ]
        }
      ]
    },
    {
      "description": "DOXEPIN 10 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-2608",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6,
          "discounted_cash": 3.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.79
            }
          ]
        }
      ]
    },
    {
      "description": "IOPAMIDOL 300 MG IODINE/ML (61 %) INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "50",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-27737",
          "type": "CDM"
        },
        {
          "code": "Q9967",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 21.9,
          "discounted_cash": 14.23,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19,
              "estimated_amount": 19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19,
              "estimated_amount": 19
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19,
              "estimated_amount": 19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19,
              "estimated_amount": 19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.84
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 17.72
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19,
              "estimated_amount": 19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.38,
              "estimated_amount": 16.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.38,
              "estimated_amount": 16.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19,
              "estimated_amount": 19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.73
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 19.27
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 5.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19,
              "estimated_amount": 19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19,
              "estimated_amount": 19
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19,
              "estimated_amount": 19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 19.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.84
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.96
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 14.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19,
              "estimated_amount": 19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19,
              "estimated_amount": 19
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19,
              "estimated_amount": 19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.84
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19,
              "estimated_amount": 19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.38,
              "estimated_amount": 16.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.84
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.99
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 19.21
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.38,
              "estimated_amount": 16.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.96
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19,
              "estimated_amount": 19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.99
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.84
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19,
              "estimated_amount": 19
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.38,
              "estimated_amount": 16.38
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 17.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19,
              "estimated_amount": 19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.84
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19,
              "estimated_amount": 19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.96
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            }
          ],
          "minimum": 16.38,
          "maximum": 19
        }
      ]
    },
    {
      "description": "ZONISAMIDE 100 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-27780",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.9,
          "discounted_cash": 3.83,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.02
            }
          ]
        }
      ]
    },
    {
      "description": "FENTANYL 75 MCG/HR TRANSDERMAL PATCH",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-27907",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 55.25,
          "discounted_cash": 35.91,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.97
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 35.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 35.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 45.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 41.44
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 41.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.47
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 48.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.92
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 36.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 48.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 35.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 30.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 45.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 30.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 35.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 30.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 45.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.96
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.47
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 41.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 48.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.92
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 44.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 30.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.31
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 55.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 44.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 35.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 55.25
            }
          ]
        }
      ]
    },
    {
      "description": "ELECTROLYTE-A INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "1000",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-28113",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 71.35,
          "discounted_cash": 46.38,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 57.72
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 46.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 71.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 59.15
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.81
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 62.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.51
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 62.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 46.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 46.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 59.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.51
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 47.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 46.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 62.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 19.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 57.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 71.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 46.31
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 46.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 46.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 44.81
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 39.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 46.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 46.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 59.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 46.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.65
            }
          ]
        }
      ]
    },
    {
      "description": "NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-28810",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 332.5,
          "discounted_cash": 216.12,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 242.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 275.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 182.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 184.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 275.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 272.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 291.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 208.81
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 90.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 282.63
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 249.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 282.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 182.88
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 332.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.14
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 282.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 282.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 272.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 208.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.47
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 219.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 272.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 215.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 215.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 215.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 182.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 242.73
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 216.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 208.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 272.65
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 282.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.47
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 292.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 275.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 272.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 242.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 272.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 216.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 208.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 215.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 254.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 216.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 282.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 249.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 208.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 184.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 184.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 291.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 216.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 242.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 208.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 208.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 282.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 182.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 216.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 208.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 249.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 268.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 216.46
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 282.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 210.14
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 282.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 272.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 182.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 182.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 272.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 268.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 208.81
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 282.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 332.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 213.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 208.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 184.54
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 282.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 208.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 208.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 208.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 182.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 242.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 242.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 282.63
            }
          ]
        }
      ]
    },
    {
      "description": "FENTANYL (PF) 2 MCG/ML-BUPIVACAINE 0.1 %-NACL INJECTION SOLUTION",
      "drug_information": {
        "unit": "250",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-30863",
          "type": "CDM"
        },
        {
          "code": "J7999",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1109.25,
          "discounted_cash": 721.01,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 847.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 610.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 722.12
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 302.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 809.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 712.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 701.05
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 732.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 809.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 712.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 847.47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 942.86
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 972.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 610.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 610.09
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 942.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 722.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 831.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 909.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 615.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 831.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 942.86
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 909.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 615.63
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 942.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 897.38
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 942.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 701.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 809.75
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 942.86
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 942.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 610.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 615.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 909.59
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 701.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1109.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 909.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 712.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 847.47
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 610.09
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 847.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 712.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 712.14
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 809.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 909.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 722.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 615.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 831.94
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 942.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 610.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 919.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 712.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 712.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 712.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 701.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 701.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 722.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 942.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 712.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 942.86
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 942.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 712.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 701.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 712.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 610.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 919.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 942.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 909.59
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 809.75
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 721.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 712.14
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 242.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 809.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 701.05
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 847.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 701.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 942.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 897.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 909.59
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 909.59
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 972.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 722.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1109.25,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 847.47
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 942.86
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 976.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 919.57
            }
          ]
        }
      ]
    },
    {
      "description": "PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-31025",
          "type": "CDM"
        },
        {
          "code": "J9267",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 109.6,
          "discounted_cash": 71.24,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 71.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 71.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.1,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 80.01
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 69.27
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 60.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.87
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 60.28
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.1,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.1,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 60.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 90.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.1,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 82.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.1,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.1,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.73
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 71.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 69.27
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 72.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.1,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 80.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.1,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.36
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 69.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.72,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 69.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 69.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 69.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 71.35
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.1,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.16
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 80.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 69.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 60.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.87
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.72,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.72,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 88.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 96.12
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 60.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.1,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.1,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.1,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 60.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.87
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 29.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 80.01
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 60.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 90.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.72,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 90.86
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.16
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 71.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 71.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.1,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.16
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 96.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 96.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 82.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 88.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.1,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.72,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.1,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 80.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 80.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.1,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 109.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 69.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 82.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.1,
              "estimated_amount": 8.1
            }
          ],
          "minimum": 7.72,
          "maximum": 8.1
        }
      ]
    },
    {
      "description": "FLUPHENAZINE 1 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-3218",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.8,
          "discounted_cash": 3.77,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.81
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.64
            }
          ]
        }
      ]
    },
    {
      "description": "FOLIC ACID 5 MG/ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "0.2",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-3232",
          "type": "CDM"
        },
        {
          "code": "J3490",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 38.15,
          "discounted_cash": 24.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 33.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.63
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 33.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 25.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 33.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.63
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.86
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 24.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 10.41
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.84
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 29.15
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.84
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 38.15,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 29.15
            }
          ]
        }
      ]
    },
    {
      "description": "FUROSEMIDE 10 MG/ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "2",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-3291",
          "type": "CDM"
        },
        {
          "code": "J1940",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 37.45,
          "discounted_cash": 24.34,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.08,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 24.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.38
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.34
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.08,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.08,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.43,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.08,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 32.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.08,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.08,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.08,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.08,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.34
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.08,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 32.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.43,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.43,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.08,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 10.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.43,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.08,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 24.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.08,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.08,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.08,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.08,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.43,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 32.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.08,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.08,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.71
            }
          ],
          "minimum": 1.08,
          "maximum": 1.43
        }
      ]
    },
    {
      "description": "VALSARTAN 40 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-33541",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.65,
          "discounted_cash": 4.32,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.83
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.65
            }
          ]
        }
      ]
    },
    {
      "description": "GENTAMICIN 0.1 % TOPICAL OINTMENT",
      "drug_information": {
        "unit": "15",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-3424",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 156.5,
          "discounted_cash": 101.72,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.91
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 133.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 133.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 114.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 101.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 86.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 129.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 137.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 137.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 86.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 128.33
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 137.72
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 101.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 128.33
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 42.72
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 133.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 98.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 101.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 86.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 128.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 133.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 128.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 98.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 133.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 101.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 98.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 98.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 119.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 98.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 98.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 86.08
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 133.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 133.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 119.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 119.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 119.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 101.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 119.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 133.03
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 103.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 98.28
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 133.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 101.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 98.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 133.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 114.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 128.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 128.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.47
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 133.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 126.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 114.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 86.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 86.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 119.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 117.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 101.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 86.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 129.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 117.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 114.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 98.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 98.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 101.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.91
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 117.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 86.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 114.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 86.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 129.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 128.33
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 133.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 126.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 114.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 156.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 101.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 101.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 98.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 86.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 86.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 98.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 98.91
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 156.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 100.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 128.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 98.28
            }
          ]
        }
      ]
    },
    {
      "description": "CLOBETASOL-EMOLLIENT 0.05 % TOPICAL CREAM",
      "drug_information": {
        "unit": "30",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-34484",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 147.8,
          "discounted_cash": 96.07,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 119.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 92.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 92.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 122.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 95.92
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 147.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 92.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 147.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 92.82
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 110.85
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 92.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.2
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 130.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.89
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 110.85
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 96.07
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 110.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 95.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 95.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 92.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.89
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 95.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.63
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.63
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 97.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 129.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.63
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 92.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 112.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 92.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 92.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 119.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 92.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 112.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 92.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 92.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 112.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 112.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 129.62
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 40.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 122.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 112.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 112.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 92.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 122.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.89
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.29
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.63
            }
          ]
        }
      ]
    },
    {
      "description": "BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-34714",
          "type": "CDM"
        },
        {
          "code": "J0574",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 13.45,
          "discounted_cash": 8.74,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 8.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 11.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.09
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 11.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 8.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 11.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            }
          ]
        }
      ]
    },
    {
      "description": "CYCLOBENZAPRINE 5 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-35184",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.85,
          "discounted_cash": 3.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.81
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.81
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.81
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.85
            }
          ]
        }
      ]
    },
    {
      "description": "HALOPERIDOL 5 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-3583",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.2,
          "discounted_cash": 4.03,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.46
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.27
            }
          ]
        }
      ]
    },
    {
      "description": "EPLERENONE 25 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-36983",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.15,
          "discounted_cash": 3.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.41
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.35
            }
          ]
        }
      ]
    },
    {
      "description": "DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-36989",
          "type": "CDM"
        },
        {
          "code": "J0878",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 107.25,
          "discounted_cash": 69.71,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 88.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 86.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 117,
              "estimated_amount": 107.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40,
              "estimated_amount": 40
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.78
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 69.71
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.78
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40,
              "estimated_amount": 40
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40,
              "estimated_amount": 40
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 88.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.95
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 117,
              "estimated_amount": 107.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40,
              "estimated_amount": 40
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.29
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.16
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.16
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.16
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 117,
              "estimated_amount": 107.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 80.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.99
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40,
              "estimated_amount": 40
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40,
              "estimated_amount": 40
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 70.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 117,
              "estimated_amount": 107.25
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.78
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 94.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40,
              "estimated_amount": 40
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40,
              "estimated_amount": 40
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40,
              "estimated_amount": 40
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40,
              "estimated_amount": 40
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 80.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.29
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 117,
              "estimated_amount": 107.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.95
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.16
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 94.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 80.44
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40,
              "estimated_amount": 40
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40,
              "estimated_amount": 40
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40,
              "estimated_amount": 40
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 86.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40,
              "estimated_amount": 40
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 94.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40,
              "estimated_amount": 40
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40,
              "estimated_amount": 40
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 91.16
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.82
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 88.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 78.29
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 40,
              "estimated_amount": 40
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 107.25,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 40,
          "maximum": 117
        }
      ]
    },
    {
      "description": "HYDROCORTISONE 0.5 % TOPICAL CREAM",
      "drug_information": {
        "unit": "30",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-3725",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.75,
          "discounted_cash": 1.79,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.79
            }
          ]
        }
      ]
    },
    {
      "description": "PROPAFENONE ER 225 MG CAPSULE,EXTENDED RELEASE 12 HR",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-37643",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 22.25,
          "discounted_cash": 14.46,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.91
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 22.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 14.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 14.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 19.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 22.25
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 19.58
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 14.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.97
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 14.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.24
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.25
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 6.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.28
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.97
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 19.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 14.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
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              "standard_charge_percentage": 80.9,
              "estimated_amount": 18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 14.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 18.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.28
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 13.97
            }
          ]
        }
      ]
    },
    {
      "description": "NYSTATIN 100,000 UNIT/GRAM TOPICAL POWDER",
      "drug_information": {
        "unit": "15",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-39136",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 35.45,
          "discounted_cash": 23.04,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.67
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 23.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 23.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31.09
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 31.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 23.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.59
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 23.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.4
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 23.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.67
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 23.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 22.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.07
            }
          ]
        }
      ]
    },
    {
      "description": "DEXTROSE 5 % AND 0.45 % NACL IV BOLUS",
      "drug_information": {
        "unit": "250",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-400295",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 60.85,
          "discounted_cash": 39.55,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 46.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 45.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 33.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.72
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 53.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 46.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.9
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.07
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.21
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 33.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 50.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 53.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 33.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 39.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.07
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 49.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 33.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 53.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 46.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 49.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 39.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 50.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.47
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 39.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 60.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 46.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.46
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.21
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 16.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 50.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.72
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 45.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 46.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 46.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 45.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 39.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.21
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 60.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 39.55
            }
          ]
        }
      ]
    },
    {
      "description": "DEXTROSE 5 % IN LACTATED RINGERS IV BOLUS",
      "drug_information": {
        "unit": "500",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-400297",
          "type": "CDM"
        },
        {
          "code": "J7121",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 62.95,
          "discounted_cash": 40.92,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 41.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 50.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 50.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.95
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.62
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.95
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.21
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 62.95
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 40.92
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.78
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.41
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 55.4
            }
          ]
        }
      ]
    },
    {
      "description": "PREGABALIN 25 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-42162",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 47.3,
          "discounted_cash": 30.74,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 26.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 41.48
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 35.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 47.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 39.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 26.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 31.22
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 39.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 26.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 30.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 30.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 30.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.21
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 26.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 38.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 38.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 41.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 30.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.21
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 30.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 41.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 35.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 35.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.14
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.79
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 40.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 39.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.79
            }
          ]
        }
      ]
    },
    {
      "description": "PREGABALIN 75 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-42164",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.8,
          "discounted_cash": 6.37,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "UHC [625]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "ANTHEM [335]",
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              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.12
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.29
            }
          ]
        }
      ]
    },
    {
      "description": "LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION",
      "drug_information": {
        "unit": "17.5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-4393",
          "type": "CDM"
        },
        {
          "code": "J0640",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 120.9,
          "discounted_cash": 78.58,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 77.21,
              "estimated_amount": 77.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 77.21,
              "estimated_amount": 77.21
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.41
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 99.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 77.21,
              "estimated_amount": 77.21
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 77.21,
              "estimated_amount": 77.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.19,
              "estimated_amount": 84.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 99.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 78.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 77.21,
              "estimated_amount": 77.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 100.23
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 78.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 99.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 97.81
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.26
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.19,
              "estimated_amount": 84.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 99.14
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 106.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.26
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.19,
              "estimated_amount": 84.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 97.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 77.21,
              "estimated_amount": 77.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 100.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 78.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 77.21,
              "estimated_amount": 77.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.26
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 77.21,
              "estimated_amount": 77.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 77.21,
              "estimated_amount": 77.21
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 78.71
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 90.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 99.14
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 90.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 77.21,
              "estimated_amount": 77.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.26
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 77.21,
              "estimated_amount": 77.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 77.21,
              "estimated_amount": 77.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 90.68
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.41
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 106.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.19,
              "estimated_amount": 84.19
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 33.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 100.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 106.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 78.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 77.21,
              "estimated_amount": 77.21
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 84.19,
              "estimated_amount": 84.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 99.14
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 79.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 77.21,
              "estimated_amount": 77.21
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 77.21,
              "estimated_amount": 77.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 77.21,
              "estimated_amount": 77.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.37
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 78.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 77.21,
              "estimated_amount": 77.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 99.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 99.14
            }
          ],
          "minimum": 77.21,
          "maximum": 84.19
        }
      ]
    },
    {
      "description": "CEFAZOLIN IVPB 2 G IN D5W 50 ML (CMP PMX)",
      "drug_information": {
        "unit": "50",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441069",
          "type": "CDM"
        },
        {
          "code": "J0690",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 91.9,
          "discounted_cash": 59.73,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 76.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.68,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.83
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 68.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.68,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.09
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.83
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 74.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 68.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 60.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 76.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.68,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 76.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 74.35
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.68,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 68.93
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.55
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 59.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 80.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.68,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 80.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 80.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.8,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.09
            }
          ],
          "minimum": 7.68,
          "maximum": 8.8
        }
      ]
    },
    {
      "description": "GENTAMICIN IRRIGATION 160 MG/1000 ML (CMP PMX)",
      "drug_information": {
        "unit": "1000",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441080",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 72.4,
          "discounted_cash": 47.06,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 63.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 47.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.47
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 58.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 63.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 63.49
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 47.78
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 47.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 47.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.47
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 54.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 46.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.48
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 46.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 60.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 47.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 72.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 54.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 46.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 60.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.82
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 58.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 40.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 40.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.47
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 72.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.76
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 47.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 40.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 60.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 46.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 54.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 40.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 47.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.47
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.76
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.82
            }
          ]
        }
      ]
    },
    {
      "description": "VANCOMYCIN ORAL 250 MG/5 ML",
      "drug_information": {
        "unit": "2.5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441089",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.95,
          "discounted_cash": 3.87,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.62
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.86
            }
          ]
        }
      ]
    },
    {
      "description": "ROPIVACAINE (PF) 2 MG/ML (0.2 %) EPIDURAL",
      "drug_information": {
        "unit": "100",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441149",
          "type": "CDM"
        },
        {
          "code": "J2795",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 123.15,
          "discounted_cash": 80.05,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 79.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 99.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32,
              "estimated_amount": 32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32,
              "estimated_amount": 32
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 102.09
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.76,
              "estimated_amount": 32.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 77.83
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 81.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 104.68
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 92.36
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 104.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 79.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 104.68
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.98
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32,
              "estimated_amount": 32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 94.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 94.09
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 80.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 80.17
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 94.09
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 77.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 104.68
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 104.68
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.98
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 79.06
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.76,
              "estimated_amount": 32.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 102.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32,
              "estimated_amount": 32
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 94.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 79.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 79.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 80.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 99.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 79.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 77.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 92.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 104.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32,
              "estimated_amount": 32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32,
              "estimated_amount": 32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.76,
              "estimated_amount": 32.76
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 104.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 92.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 80.17
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 80.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32,
              "estimated_amount": 32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32,
              "estimated_amount": 32
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 94.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 104.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 77.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 80.17
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 79.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 108
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 77.83
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 104.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32,
              "estimated_amount": 32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 79.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 77.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32,
              "estimated_amount": 32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 77.83
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 104.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32,
              "estimated_amount": 32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32,
              "estimated_amount": 32
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 100.98
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 108.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.76,
              "estimated_amount": 32.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32,
              "estimated_amount": 32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 94.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 104.68
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32.76,
              "estimated_amount": 32.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 79.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 77.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32,
              "estimated_amount": 32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 102.09
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 104.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 89.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 108
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32,
              "estimated_amount": 32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 104.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 79.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 79.06
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 79.06
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 104.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 123.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 33.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32,
              "estimated_amount": 32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 32,
              "estimated_amount": 32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 67.73
            }
          ],
          "minimum": 32,
          "maximum": 32.76
        }
      ]
    },
    {
      "description": "HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSPENSION",
      "drug_information": {
        "unit": "8",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441665",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 13.25,
          "discounted_cash": 8.61,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 11.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.67
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 8.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.98
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 11.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 13.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 8.75
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 11.62
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.87
            }
          ]
        }
      ]
    },
    {
      "description": "REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION",
      "drug_information": {
        "unit": "20",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441672",
          "type": "CDM"
        },
        {
          "code": "J0248",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3024.1,
          "discounted_cash": 1965.66,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1941.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2310.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1911.23
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 662.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2479.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1721,
              "estimated_amount": 1721
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1663.26
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3024.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1941.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2268.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1663.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1911.23
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2506.98
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1721,
              "estimated_amount": 1721
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1721,
              "estimated_amount": 1721
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1721,
              "estimated_amount": 1721
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2479.76
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1965.67
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3024.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1941.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1941.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1911.23
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1721,
              "estimated_amount": 1721
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2207.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2506.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1941.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2207.59
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1911.23
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2268.08
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2570.49
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1995.91
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2570.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1968.69
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2570.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2310.41
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1721,
              "estimated_amount": 1721
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2310.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1663.26
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3024.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2479.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1968.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2570.49
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3024.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1663.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2506.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1911.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1941.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1721,
              "estimated_amount": 1721
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2268.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2479.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1721,
              "estimated_amount": 1721
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2570.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2570.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1418.04,
              "estimated_amount": 1418.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1941.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1941.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1968.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2570.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2479.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1721,
              "estimated_amount": 1721
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2652.14
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1418.04,
              "estimated_amount": 1418.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1721,
              "estimated_amount": 1721
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1721,
              "estimated_amount": 1721
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1721,
              "estimated_amount": 1721
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1721,
              "estimated_amount": 1721
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2310.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1941.47
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2570.49
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2570.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1968.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1721,
              "estimated_amount": 1721
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1911.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1941.47
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 623.37,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2570.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1418.04,
              "estimated_amount": 1418.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2479.76
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2310.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1911.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2446.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2207.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2207.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1663.26
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1968.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1721,
              "estimated_amount": 1721
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1911.23
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1418.04,
              "estimated_amount": 1418.04
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2570.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1941.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1721,
              "estimated_amount": 1721
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1721,
              "estimated_amount": 1721
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2207.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1418.04,
              "estimated_amount": 1418.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2479.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2479.76
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2570.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1941.47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2570.49
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2570.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1663.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2207.59
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 825.58
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2661.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2310.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2652.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 593.68,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1663.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2446.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3024.1,
              "additional_payer_notes": "OUTPATIENT"
            }
          ],
          "minimum": 1418.04,
          "maximum": 1721
        }
      ]
    },
    {
      "description": "MITOMYCIN 0.4 MG/ML BLADDER NECK INJECTION SOLUTION",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441679",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 298,
          "discounted_cash": 193.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.32
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 223.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 188.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 188.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 194
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 227.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 163.9
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.3
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 262.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 188.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 244.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 247.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 241.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 227.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 188.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.14
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 81.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 244.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 261.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 188.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 163.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 244.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 261.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 244.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 193.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 165.39
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 196.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 193.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 188.34
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.3
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 298,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.14
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 193.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 188.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 247.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 223.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 217.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 165.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 163.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 298
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 244.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 227.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 193.4
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 217.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 217.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 217.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 165.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 194
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 193.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 227.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 244.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 244.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.32
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 165.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 194
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 244.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 163.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 241.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 223.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 227.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 247.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 217.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 163.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 217.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 194
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 227.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 163.9
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 188.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 194
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 163.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.14
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.3
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 591.4,
          "discounted_cash": 384.41,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 451.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 484.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 385
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 502.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 325.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 490.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 383.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 451.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 373.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 451.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 379.68
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 502.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 591.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 484.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 484.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 484.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 371.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 371.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 379.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 373.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 373.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 325.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 431.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 371.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 502.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 371.4
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 591.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 379.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 373.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 371.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 371.4
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 502.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 490.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 325.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 431.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 379.68
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 443.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 373.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 371.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 379.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 328.23
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 502.69
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 520.43
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 502.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 484.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 373.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 325.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 371.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 385
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 484.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 379.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 518.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 518.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 379.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 385
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 443.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 478.44
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 502.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 383.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 325.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 379.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 373.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 478.44
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 502.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 371.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 379.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 484.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 371.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 373.76
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 390.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 502.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 443.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 431.72
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 384.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 431.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 379.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 385
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 325.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 431.72
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 161.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 385
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 451.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 379.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 490.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 484.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 451.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 371.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 502.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 328.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 328.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 371.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 383.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 502.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 451.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 383.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 502.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 431.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 328.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 325.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 379.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 371.4
            }
          ]
        }
      ]
    },
    {
      "description": "METHADONE ORAL SOLUTION 5 MG/0.5 ML",
      "drug_information": {
        "unit": "0.5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441801",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.55,
          "discounted_cash": 6.21,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 5.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 5.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 5.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 6
            },
            {
              "payer_name": "PARAMOUNT [555]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 8.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 6
            },
            {
              "payer_name": "PARAMOUNT [555]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 8.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.21
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.12
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
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              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.16
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.16
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.55
            }
          ]
        }
      ]
    },
    {
      "description": "KETAMINE 100 MG/ML NASAL SYRINGE (NEONATE/PED)",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441845",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 39.8,
          "discounted_cash": 25.87,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.41
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.99
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 39.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 34.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 25.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.89
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 35.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.83
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 25.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 32.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 34.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.55
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 10.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 32.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.89
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.83
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.64
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 25.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.83
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 26.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 25.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 25.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 39.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.99
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.83
            }
          ]
        }
      ]
    },
    {
      "description": "SODIUM PHOSPHATE P-32, THERAPEUTIC, PER MILLICURIE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-451038",
          "type": "CDM"
        },
        {
          "code": "A9563",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.05,
          "discounted_cash": 0.03,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "estimated_amount": 0.05,
              "additional_payer_notes": "SRD < $1"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            }
          ]
        }
      ]
    },
    {
      "description": "LORAZEPAM 1 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-4573",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.55,
          "discounted_cash": 5.56,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.57
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.75
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.27
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.27
            }
          ]
        }
      ]
    },
    {
      "description": "DEXAMETHASONE 10 MG/ML INJ SOLN SORD",
      "drug_information": {
        "unit": "0.5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-461016",
          "type": "CDM"
        },
        {
          "code": "J1100",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 34.85,
          "discounted_cash": 22.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.37
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.03
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 23
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.03
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.4,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.58
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.17
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.44
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 22.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.19
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.4,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.44
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.03
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.63
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.63
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.4,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.69
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.03
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 30.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.4,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.4,
              "estimated_amount": 1.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.89
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.9,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.17
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.37
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.5,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.58
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.58
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.62
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.58
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.17
            }
          ],
          "minimum": 0.9,
          "maximum": 1.5
        }
      ]
    },
    {
      "description": "POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAP SORD",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-461019",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5,
          "discounted_cash": 3.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            }
          ]
        }
      ]
    },
    {
      "description": "FOLIC ACID-VIT B6-VIT B12 TABLET SORD",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-461021",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.85,
          "discounted_cash": 4.45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.01
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.85
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.82
            }
          ]
        }
      ]
    },
    {
      "description": "NEOSTIGMINE METHYLSULFATE 1 MG/ML INJECTION SOLUTION SORD",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-461039",
          "type": "CDM"
        },
        {
          "code": "J2710",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 43.35,
          "discounted_cash": 28.18,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.12
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 35.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 98.2,
              "estimated_amount": 98.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 98.2,
              "estimated_amount": 98.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.55
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 98.2,
              "estimated_amount": 98.2
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 38.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.44,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 28.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.12
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.44,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 98.2,
              "estimated_amount": 98.2
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 98.2,
              "estimated_amount": 98.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.4
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 35.07
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 98.2,
              "estimated_amount": 98.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.55
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 28.18
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.84
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.83
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 98.2,
              "estimated_amount": 98.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 35.94
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.22
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 98.2,
              "estimated_amount": 98.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.55
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.55
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 98.2,
              "estimated_amount": 98.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 98.2,
              "estimated_amount": 98.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 98.2,
              "estimated_amount": 98.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.44,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 38.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.22
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.44,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 35.94
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.22
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 11.83
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 37.44,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 38.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 98.2,
              "estimated_amount": 98.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 98.2,
              "estimated_amount": 98.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 98.2,
              "estimated_amount": 98.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 35.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 98.2,
              "estimated_amount": 98.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 98.2,
              "estimated_amount": 98.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 98.2,
              "estimated_amount": 98.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.84
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.35,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.55
            }
          ],
          "minimum": 37.44,
          "maximum": 98.2
        }
      ]
    },
    {
      "description": "BUPROPION HCL SR 150 MG TABLET SORD",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-461043",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.75,
          "discounted_cash": 3.74,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            }
          ]
        }
      ]
    },
    {
      "description": "METHOTREXATE SODIUM 25 MG/ML INJECTION FOR ECTOPIC PREGNANCY (SORD)",
      "drug_information": {
        "unit": "2",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-461075",
          "type": "CDM"
        },
        {
          "code": "J9260",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 110.05,
          "discounted_cash": 71.53,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 84.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 84.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 80.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 91.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 90.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.65
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.65
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.54
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 60.53
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 69.55
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 60.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 60.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 60.53
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 90.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 80.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 69.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 84.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 84.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 91.23
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 82.54
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 96.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 84.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 89.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 80.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.01,
              "estimated_amount": 6.01
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 71.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 84.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 60.53
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 69.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 69.55
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 69.55
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.01,
              "estimated_amount": 6.01
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 82.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 69.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 89.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 82.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 80.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 72.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 71.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.01,
              "estimated_amount": 6.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 90.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 90.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 90.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.01,
              "estimated_amount": 6.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 96.51
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 71.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.54
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 71.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 91.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 90.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 80.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 69.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 90.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 96.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 69.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 80.34
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 71.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.01,
              "estimated_amount": 6.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 90.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 71.64
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.65
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 110.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 30.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.37,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 93.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 60.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 60.53
            }
          ],
          "minimum": 6.01,
          "maximum": 7.37
        },
        {
          "setting": "outpatient",
          "gross_charge": 181.8,
          "discounted_cash": 118.17,
          "payers_information": [
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 114.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 114.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.07,
              "estimated_amount": 30.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 147.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 118.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 132.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.07,
              "estimated_amount": 30.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 99.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 149.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 114.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 118.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 132.71
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.53
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 119.99
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 118.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 114.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.07,
              "estimated_amount": 30.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.07,
              "estimated_amount": 30.07
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 99.99
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.72
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 136.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 132.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 149.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 147.08
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 136.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 114.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 159.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 132.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 118.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 30.07,
              "estimated_amount": 30.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 149.08
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 118.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 138.9
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 138.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 138.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.53
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 138.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.53
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 132.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 149.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 149.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 159.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 99.99
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 149.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 138.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 114.9
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 159.98
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.53
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 49.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 138.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 114.9
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 136.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 149.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 150.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 149.08
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 118.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 99.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.72
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 99.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 99.99
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 181.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 99.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 114.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 132.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 150.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 116.72
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 150.71
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 154.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.85,
              "estimated_amount": 36.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 36.85,
              "estimated_amount": 36.85
            }
          ],
          "minimum": 30.07,
          "maximum": 36.85
        }
      ]
    },
    {
      "description": "ROCURONIUM 10 MG/ML INTRAVENOUS INJECTION (SORD)",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-461076",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 36.8,
          "discounted_cash": 23.92,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 30.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 23.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.26
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 36.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 29.77
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.26
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 32.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 32.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 30.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 23.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 23.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 30.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.18
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 32.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.86
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 23.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 29.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.26
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.86
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 24.29
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 23.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 23.88
            }
          ]
        }
      ]
    },
    {
      "description": "AMPICILLIN 250 MG SOLUTION FOR INJECTION",
      "drug_information": {
        "unit": "0.25",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-473",
          "type": "CDM"
        },
        {
          "code": "J0290",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 48.45,
          "discounted_cash": 31.49,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.54
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.11,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.11,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.11,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.34,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.34,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 31.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.11,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.65
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 40.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 40.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.73
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.54
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.73
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 42.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.11,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.11,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.34,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 42.49
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.11,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 40.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.73
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 39.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.62
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.11,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 42.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.11,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.11,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.11,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.11,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.34,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.11,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.11,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.11,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.62
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.34,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.65
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 31.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 31.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.11,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.37
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 39.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 26.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 39.73
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 48.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 35.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 30.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.11,
              "estimated_amount": 2.11
            }
          ],
          "minimum": 2.11,
          "maximum": 2.34
        }
      ]
    },
    {
      "description": "INV DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "100",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-491020",
          "type": "CDM"
        },
        {
          "code": "25600001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.65,
          "discounted_cash": 0.42,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            }
          ]
        }
      ]
    },
    {
      "description": "INV PALBOCICLIB 100 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-491642",
          "type": "CDM"
        },
        {
          "code": "25600001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.65,
          "discounted_cash": 0.42,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            }
          ]
        }
      ]
    },
    {
      "description": "MORPHINE 10 MG/5 ML ORAL SOLUTION",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-5176",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 13.45,
          "discounted_cash": 8.74,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 11.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 8.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 11.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 11.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.09
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 8.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.46
            }
          ]
        }
      ]
    },
    {
      "description": "OXYTOCIN 10 UNIT/ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "0.3",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-5944",
          "type": "CDM"
        },
        {
          "code": "J2590",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 34.3,
          "discounted_cash": 22.29,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.45,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.45,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.28,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 30.18
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.45,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.45,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.45,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.45,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.28,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 22.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.45,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 22.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.45,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.45,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.45,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.21
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.28,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 27.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.13
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.45,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.45,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.45,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.73
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 27.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.28,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.45,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.28,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.02
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.45,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.45,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.45,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.68
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.68
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.3,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.87
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.73
            }
          ],
          "minimum": 3.28,
          "maximum": 5.45
        }
      ]
    },
    {
      "description": "PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-6086",
          "type": "CDM"
        },
        {
          "code": "J2540",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 92,
          "discounted_cash": 59.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.66,
              "estimated_amount": 24.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.48,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.14
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 80.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.66,
              "estimated_amount": 24.66
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 76.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 92,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 60.72
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.66,
              "estimated_amount": 24.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 74.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 74.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.66,
              "estimated_amount": 24.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 92,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 92,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.14
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 59.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 25.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.66,
              "estimated_amount": 24.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.66,
              "estimated_amount": 24.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.16
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 80.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.48,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.66,
              "estimated_amount": 24.66
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 92,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.66,
              "estimated_amount": 24.66
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 92,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.48,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.66,
              "estimated_amount": 24.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.66,
              "estimated_amount": 24.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.48,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.66,
              "estimated_amount": 24.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.66,
              "estimated_amount": 24.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.66,
              "estimated_amount": 24.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 78.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.6
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 92,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 76.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.29
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 80.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.66,
              "estimated_amount": 24.66
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.66,
              "estimated_amount": 24.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.66,
              "estimated_amount": 24.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24.66,
              "estimated_amount": 24.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.14
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 70.29
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 92,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 75.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.48,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 76.27
            }
          ],
          "minimum": 17.48,
          "maximum": 24.66
        }
      ]
    },
    {
      "description": "PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "0.01",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-6242",
          "type": "CDM"
        },
        {
          "code": "J2371",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 33.05,
          "discounted_cash": 21.48,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.15,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.12,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 28.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.15,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.15,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.13
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 29.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.15,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.52
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.89
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.12,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 27.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.12,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 27.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.15,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 33.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.18
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 33.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 24.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.15,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 24.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.15,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.15,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.52
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 33.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.15,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.22
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 33.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.15,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.15,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 26.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 21.81
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 27.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.15,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.12,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.15,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.15,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.15,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 21.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 24.79
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 33.05,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 33.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.89
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 26.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.12,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.15,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.15,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 20.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 28.98
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.18
            }
          ],
          "minimum": 0.12,
          "maximum": 0.15
        }
      ]
    },
    {
      "description": "PRIMIDONE 250 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-6544",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.45,
          "discounted_cash": 3.54,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
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              "standard_charge_percentage": 66,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            }
          ]
        }
      ]
    },
    {
      "description": "PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-6620",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.85,
          "discounted_cash": 6.4,
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            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
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              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.69
            },
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              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
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              "standard_charge_percentage": 75,
              "estimated_amount": 7.39
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.39
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 7.19
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
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              "standard_charge_percentage": 75,
              "estimated_amount": 7.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
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              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "MMO [485]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 7.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.39
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.4
            }
          ]
        }
      ]
    },
    {
      "description": "ANTIHEMOPHILIC FACTOR-VWF 1,000 UNIT-2,400 UNIT INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-70406",
          "type": "CDM"
        },
        {
          "code": "J7187",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10317.2,
          "discounted_cash": 6706.18,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6623.64
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10317.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7862.4,
              "estimated_amount": 7862.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8552.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5674.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9096,
              "estimated_amount": 9096
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8769.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8769.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5674.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7862.4,
              "estimated_amount": 7862.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8552.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6623.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8346.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6623.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7531.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9096,
              "estimated_amount": 9096
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1857.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9096,
              "estimated_amount": 9096
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7882.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6716.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9096,
              "estimated_amount": 9096
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8769.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9096,
              "estimated_amount": 9096
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6623.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7882.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6623.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6623.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6623.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8769.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8769.62
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10317.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6716.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7531.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6520.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8769.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7882.34
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8769.62
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8769.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6623.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6623.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9096,
              "estimated_amount": 9096
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9096,
              "estimated_amount": 9096
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5674.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7862.4,
              "estimated_amount": 7862.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7862.4,
              "estimated_amount": 7862.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8460.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6623.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9048.18
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1857.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8460.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9096,
              "estimated_amount": 9096
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 2259.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6520.47
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6706.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6520.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8769.62
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9079.14
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6520.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9096,
              "estimated_amount": 9096
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6809.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7531.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7531.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6716.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8460.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8769.62
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7882.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6520.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7737.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9048.18
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2816.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8769.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9096,
              "estimated_amount": 9096
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8460.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6623.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8346.61
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9096,
              "estimated_amount": 9096
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8769.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7737.9
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8460.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7862.4,
              "estimated_amount": 7862.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8769.62
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7737.9
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9096,
              "estimated_amount": 9096
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5674.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7531.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8460.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6716.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6520.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6520.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9096,
              "estimated_amount": 9096
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9096,
              "estimated_amount": 9096
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5674.46
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3450.03,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9096,
              "estimated_amount": 9096
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7531.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8552.96
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10317.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8460.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5674.46
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6623.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9096,
              "estimated_amount": 9096
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8769.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6520.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8460.1
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3285.74,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6716.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7882.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9096,
              "estimated_amount": 9096
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5674.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7882.34
            }
          ],
          "minimum": 7862.4,
          "maximum": 9096
        }
      ]
    },
    {
      "description": "NEOMYCIN 40 MG-POLYMYXIN B 200,000 UNIT/ML GU IRRIGATION SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-70678",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 83.65,
          "discounted_cash": 54.37,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 54.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 52.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 52.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 54.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 73.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 52.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 54.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 63.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 63.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 46.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 52.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 52.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 62.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 63.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 46.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 54.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.7
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 55.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 69.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 54.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 62.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 54.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 52.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 54.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 83.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 69.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 54.46
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 73.61
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 52.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 52.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 52.53
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 83.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 73.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 46.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 52.53
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 22.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 52.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 52.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 54.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 63.91
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 62.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 46.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 69.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.06
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 67.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 67.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 63.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 63.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 54.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 52.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.59
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.06
            }
          ]
        }
      ]
    },
    {
      "description": "SODIUM CHLORIDE 0.9 % FOR NEBULIZATION",
      "drug_information": {
        "unit": "3",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-7325",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.45,
          "discounted_cash": 3.54,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.41
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.41
            }
          ]
        }
      ]
    },
    {
      "description": "SPIRONOLACTONE 25 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-7437",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5,
          "discounted_cash": 3.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            }
          ]
        }
      ]
    },
    {
      "description": "HYDROCHLOROTHIAZIDE 12.5 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-76988",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.8,
          "discounted_cash": 3.12,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.01
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.08
            }
          ]
        }
      ]
    },
    {
      "description": "FLUTICASONE PROPIONATE 45 MCG-SALMETEROL 21 MCG/ACTUATION HFA INHALER",
      "drug_information": {
        "unit": "8",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-77173",
          "type": "CDM"
        },
        {
          "code": "J3535",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 93.7,
          "discounted_cash": 60.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 93.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 76.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.65
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 61.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 76.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 82.17
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.54
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 70.28
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 25.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 76.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.4
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.22
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 76.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 75.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 77.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 76.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 76.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 70.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 75.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 76.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.22
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 82.17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 70.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 77.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 52
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 60.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 76.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 93.7,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.65
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 82.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 77.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.65
            }
          ]
        }
      ]
    },
    {
      "description": "FLUTICASONE PROPIONATE 230 MCG-SALMETEROL 21 MCG/ACTUATION HFA INHALER",
      "drug_information": {
        "unit": "0.000502",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-77175",
          "type": "CDM"
        },
        {
          "code": "J3535",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.65,
          "discounted_cash": 5.62,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.63
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            }
          ]
        }
      ]
    },
    {
      "description": "THIORIDAZINE 10 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-7894",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.6,
          "discounted_cash": 3.64,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            }
          ]
        }
      ]
    },
    {
      "description": "TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT",
      "drug_information": {
        "unit": "15",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-8118",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 23.9,
          "discounted_cash": 15.53,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.1
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 15.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 15.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.45
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 15.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 15.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.93
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 21.03
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.6
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.01
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 23.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.1
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 15.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 15.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 20.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 23.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 20.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 19.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 17.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.01
            }
          ]
        }
      ]
    },
    {
      "description": "CLOPIDOGREL 300 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-89346",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 29.3,
          "discounted_cash": 19.04,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "FIRST HEALTH [408]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 24.91
            },
            {
              "payer_name": "COVENTRY [406]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 24.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 24.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
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              "standard_charge_percentage": 100,
              "estimated_amount": 29.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 24.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
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              "standard_charge_percentage": 75,
              "estimated_amount": 21.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.39
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.39
            },
            {
              "payer_name": "MMO [485]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 25.7
            },
            {
              "payer_name": "ANTHEM [335]",
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              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.26
            },
            {
              "payer_name": "GREATWEST [550]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 24.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 24.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 16.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.52
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 21.39
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 21.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 24.03
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
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              "standard_charge_percentage": 75,
              "estimated_amount": 21.98
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.07
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 87.7,
              "estimated_amount": 25.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 21.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 24.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 23.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 24.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 16.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 24.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.91
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 19.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 19.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 24.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 16.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.52
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 24.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.39
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 21.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.39
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 19.05
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "ANTHEM [335]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.26
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 21.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 19.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 19.02
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 19.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.52
            },
            {
              "payer_name": "AETNA [310]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 22.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 18.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 21.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 16.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.91
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 29.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 24.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 24.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 23.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 19.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 16.12
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 25.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 18.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 18.4
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 24.91
            }
          ]
        }
      ]
    },
    {
      "description": "ALPROSTADIL 500 MCG/ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-9001",
          "type": "CDM"
        },
        {
          "code": "J0270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 640.95,
          "discounted_cash": 416.62,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 489.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 489.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 476,
              "estimated_amount": 476
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9612.72,
              "estimated_amount": 640.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 525.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 467.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 467.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 531.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 476,
              "estimated_amount": 476
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 476,
              "estimated_amount": 476
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 476,
              "estimated_amount": 476
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.81
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 480.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 476,
              "estimated_amount": 476
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 476,
              "estimated_amount": 476
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9612.72,
              "estimated_amount": 640.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 531.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 417.26
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 467.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 417.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 405.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 476,
              "estimated_amount": 476
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 640.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.81
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 423.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 476,
              "estimated_amount": 476
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 405.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 531.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9612.72,
              "estimated_amount": 640.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 476,
              "estimated_amount": 476
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 480.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 476,
              "estimated_amount": 476
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.81
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 562.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 489.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 476,
              "estimated_amount": 476
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 640.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 518.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 562.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 467.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352.52
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 416.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 476,
              "estimated_amount": 476
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 525.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.49
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 640.95,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 405.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9612.72,
              "estimated_amount": 640.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 525.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 417.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 476,
              "estimated_amount": 476
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 405.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 405.08
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 564.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 525.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 417.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 518.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 476,
              "estimated_amount": 476
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 174.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 467.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 467.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 476,
              "estimated_amount": 476
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 476,
              "estimated_amount": 476
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 405.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 525.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 489.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 489.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.81
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 640.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.81
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 525.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 525.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 411.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 405.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9612.72,
              "estimated_amount": 640.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 525.58
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 489.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 476,
              "estimated_amount": 476
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 480.71
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 640.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 405.08
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 640.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 544.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 352.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 417.26
            }
          ],
          "minimum": 476,
          "maximum": 9612.72
        }
      ]
    },
    {
      "description": "ALTEPLASE 100 MG INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "100",
        "type": "ME"
      },
      "code_information": [
        {
          "code": "RX-9002",
          "type": "CDM"
        },
        {
          "code": "J2997",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 35757.2,
          "discounted_cash": 23242.18,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26817.9
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 23599.75
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9761.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26102.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20783.88,
              "estimated_amount": 20783.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19666.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23277.94
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26817.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29320.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27318.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19666.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26102.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29642.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31359.06
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31359.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20783.88,
              "estimated_amount": 20783.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 6436.3
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35757.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29320.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29320.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19666.46
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 31466.34
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23277.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28927.57
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9139.78,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22598.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29320.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29642.72
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19666.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27318.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26102.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22598.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26102.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29320.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27318.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29320.9
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35757.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22598.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27318.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26102.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19666.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29320.9
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 7830.83
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35757.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28927.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22598.55
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23277.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29320.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27318.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22598.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 23242.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22598.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19666.46
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 6436.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20783.88,
              "estimated_amount": 20783.88
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19666.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22598.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20783.88,
              "estimated_amount": 20783.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27318.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26817.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29642.72
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22598.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26102.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23277.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20783.88,
              "estimated_amount": 20783.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23277.94
            }
          ],
          "minimum": 20783.88,
          "maximum": 24753
        }
      ]
    },
    {
      "description": "LUBIPROSTONE 8 MCG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-91534",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 42.6,
          "discounted_cash": 27.69,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 35.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.73
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 23.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 37.49
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 28.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 42.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 34.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 35.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.92
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 23.64
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 35.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 27.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.43
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 37.36
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 42.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 27.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 27.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 34.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 27.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 23.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 11.63
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 27.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 37.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 23.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.75
            }
          ]
        }
      ]
    },
    {
      "description": "CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION",
      "drug_information": {
        "unit": "2",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-9488",
          "type": "CDM"
        },
        {
          "code": "J0696",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 45.75,
          "discounted_cash": 29.74,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 34.31
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.42,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.52,
              "estimated_amount": 9.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.52,
              "estimated_amount": 9.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.52,
              "estimated_amount": 9.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 37.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 37.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.78
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 40.12
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.52,
              "estimated_amount": 9.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.42,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.52,
              "estimated_amount": 9.52
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.4
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.37
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.89
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.89
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 29.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 40.12
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.89
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.52,
              "estimated_amount": 9.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 37.52
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 34.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.91
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 30.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.52,
              "estimated_amount": 9.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 37.52
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.52,
              "estimated_amount": 9.52
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.52,
              "estimated_amount": 9.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.52,
              "estimated_amount": 9.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.37
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.52,
              "estimated_amount": 9.52
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 34.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.89
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 47.04,
              "estimated_amount": 47.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 37.52
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.52,
              "estimated_amount": 9.52
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 37.52
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.89
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 37.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.52,
              "estimated_amount": 9.52
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.42,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.52,
              "estimated_amount": 9.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.42,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 37.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 37.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.52,
              "estimated_amount": 9.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.52,
              "estimated_amount": 9.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.52,
              "estimated_amount": 9.52
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 45.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 37.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 37.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 8.42,
              "estimated_amount": 8.42
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 37.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 37.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.89
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.91
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 40.26
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.89
            }
          ],
          "minimum": 8.42,
          "maximum": 47.04
        }
      ]
    },
    {
      "description": "QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-95676",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5,
          "discounted_cash": 3.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            }
          ]
        }
      ]
    },
    {
      "description": "CIPROFLOXACIN 0.3 % EYE DROPS",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-9610",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 62.7,
          "discounted_cash": 40.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 54.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 50.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.3
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.12
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 55.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 51.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.63
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 40.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.63
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 54.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 40.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 62.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 40.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 40.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 40.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.3
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.3
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 51.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 51.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.9
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 53.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.49
            }
          ]
        }
      ]
    },
    {
      "description": "CLINDAMYCIN 2 % VAGINAL CREAM",
      "drug_information": {
        "unit": "8",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-9624",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 299.1,
          "discounted_cash": 194.41,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 192.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 262.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 245.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 164.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 194.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 194.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 192.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 218.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 192.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 218.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 241.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 189.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 192.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 245.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 189.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 192.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 247.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 189.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 164.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 192.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 189.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 194.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 254.24
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 224.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 245.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 218.34
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 254.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 192.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 245.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 189.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 254.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 245.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 247.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 254.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 164.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 189.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 166
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 81.65
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 254.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 164.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 166
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 245.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 194.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 166
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 164.51
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 254.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 194.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 197.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.83
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 299.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 245.26
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 254.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 245.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 192.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 224.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 194.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 241.97
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 254.24
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 254.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 262.31
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 254.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 192.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 194.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 299.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 189.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 254.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 164.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 192.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 164.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 189.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 192.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 192.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 194.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 194.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 218.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 218.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 224.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 194.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 247.95
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 263.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 254.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 218.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 166
            }
          ]
        }
      ]
    },
    {
      "description": "CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK",
      "drug_information": {
        "unit": "50",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-9627",
          "type": "CDM"
        },
        {
          "code": "J0736",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 96.05,
          "discounted_cash": 62.43,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 73.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 78.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 73.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.94,
              "estimated_amount": 15.94
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 72.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.66
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 81.64
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 96.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 81.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.7
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 96.05,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 81.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 81.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 78.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 78.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.94,
              "estimated_amount": 15.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 78.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.94,
              "estimated_amount": 15.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 62.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 62.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 79.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 78.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 81.64
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 62.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 81.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 96.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.7
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 96.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 79.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 77.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 78.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 62.53
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 81.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 73.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 81.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 73.38
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 63.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.94,
              "estimated_amount": 15.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 77.7
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 84.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 73.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 79.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 81.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 72.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 26.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 78.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 60.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 52.83
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 72.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 15.94,
              "estimated_amount": 15.94
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 81.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 84.24
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 81.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 19.44,
              "estimated_amount": 19.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 81.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 78.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 62.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 62.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 84.24
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 96.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 96.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 73.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 81.64
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 81.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 61.66
            }
          ],
          "minimum": 15.94,
          "maximum": 19.44
        }
      ]
    },
    {
      "description": "LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "20",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-96972",
          "type": "CDM"
        },
        {
          "code": "C9254",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 500.6,
          "discounted_cash": 325.39,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 382.46
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 316.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 325.89
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 275.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 275.33
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 275.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 365.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 375.45
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.51
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 440.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 275.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 275.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 410.49
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 316.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 325.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 410.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 321.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 321.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 321.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 316.38
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 375.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 410.49
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 410.49
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 275.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 382.46
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 316.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 382.46
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.51
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 365.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 365.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 325.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 316.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 321.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 410.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 404.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 439.03
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 365.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 415
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 415
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 321.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 382.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 382.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 415
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 136.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 321.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 321.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 316.38
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 275.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 365.44
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 316.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 325.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 321.39
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 382.46
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 325.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 404.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 321.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 93.6,
              "estimated_amount": 93.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 375.45
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 330.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 321.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 321.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 316.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 439.03
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 410.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.51
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 410.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 325.89
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 321.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 365.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 410.49
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 500.6,
              "additional_payer_notes": "SRD"
            }
          ],
          "minimum": 93.6,
          "maximum": 93.6
        }
      ]
    },
    {
      "description": "DANTROLENE 25 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-9718",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.6,
          "discounted_cash": 5.59,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.96
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.77
            }
          ]
        }
      ]
    },
    {
      "description": "DEFEROXAMINE 500 MG SOLUTION FOR INJECTION",
      "drug_information": {
        "unit": "500",
        "type": "ME"
      },
      "code_information": [
        {
          "code": "RX-9723",
          "type": "CDM"
        },
        {
          "code": "J0895",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 93.05,
          "discounted_cash": 60.48,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 71.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 60.58
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 93.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.11,
              "estimated_amount": 21.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 76.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 76.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 60.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 77.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 76.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.93
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 60.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 76.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 81.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 71.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 76.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 81.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 71.09
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 69.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 69.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 75.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 75.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 77.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 69.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 71.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.74
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.81
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.11,
              "estimated_amount": 21.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 77.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 76.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 76.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 67.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 60.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 59.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 71.09
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 61.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.11,
              "estimated_amount": 21.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 71.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 25.4
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 81.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.11,
              "estimated_amount": 21.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 60.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 58.81
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 79.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 18.37,
              "estimated_amount": 18.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.11,
              "estimated_amount": 21.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 60.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 76.3
            }
          ],
          "minimum": 18.37,
          "maximum": 21.11
        }
      ]
    },
    {
      "description": "POTASSIUM CHLORIDE 40 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS",
      "drug_information": {
        "unit": "1000",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-9796",
          "type": "CDM"
        },
        {
          "code": "J3480",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 75.55,
          "discounted_cash": 49.11,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.2,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 49.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6,
              "estimated_amount": 6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6,
              "estimated_amount": 6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 66.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.15,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6,
              "estimated_amount": 6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.22
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.22
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 49.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.15
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6,
              "estimated_amount": 6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6,
              "estimated_amount": 6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.15,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.22
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 66.26
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6,
              "estimated_amount": 6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6,
              "estimated_amount": 6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.75
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6,
              "estimated_amount": 6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6,
              "estimated_amount": 6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 61.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6,
              "estimated_amount": 6
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 20.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6,
              "estimated_amount": 6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6,
              "estimated_amount": 6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6,
              "estimated_amount": 6
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 66.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 61.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.15,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6,
              "estimated_amount": 6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.95
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.55
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.75
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.55
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6,
              "estimated_amount": 6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6,
              "estimated_amount": 6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.18
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.75
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.15,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6,
              "estimated_amount": 6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.15,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.72
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 75.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.75
            }
          ],
          "minimum": 3.2,
          "maximum": 6
        }
      ]
    },
    {
      "description": "ESTRADIOL 1 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-9967",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.95,
          "discounted_cash": 3.22,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.13
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.21
            }
          ]
        }
      ]
    },
    {
      "description": "BENZTROPINE 1 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-999",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.6,
          "discounted_cash": 3.64,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            }
          ]
        }
      ]
    },
    {
      "description": "PLATE 3.5 X 85MM 6HL LT CLAVICLE SUPERIOR LCP",
      "code_information": [
        {
          "code": "SUP-02.112.081",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1996.5,
          "discounted_cash": 1297.72,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1279.76
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 545.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1525.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1525.33
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1497.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1217.87
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1756.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1279.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1108.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1655.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1217.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1217.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1697.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1098.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1279.76
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1299.72
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1307.71
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 437.23
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1697.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1697.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1275.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1697.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1615.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1299.72
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1217.87
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1637.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1697.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1655.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1217.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1637.13
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1750.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1307.71
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1098.08
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1317.69
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1525.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1307.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1307.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1279.76
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1697.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1497.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1217.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1275.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1279.76
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1525.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1108.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1637.13
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1307.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1525.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1217.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1457.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1457.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1637.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1299.72
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1655.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1697.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1279.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1279.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1217.87
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1098.08
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1697.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1457.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1457.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1098.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1637.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1098.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1307.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1275.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1098.08
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1299.72
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1697.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1307.71
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1697.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1996.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1275.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1217.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1637.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1217.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1299.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1457.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1108.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1637.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1297.73
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1497.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1457.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1279.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1279.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1697.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1637.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1279.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1217.87
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1697.03
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1697.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1098.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1525.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1750.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1279.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1279.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1697.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1108.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1217.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1217.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1307.71
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1996.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1615.17
            }
          ]
        }
      ]
    },
    {
      "description": "CARTRIDGE 12MM 60 RELOAD BLUE FLEX ECHELON",
      "code_information": [
        {
          "code": "SUP-GST60B",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 502.76,
          "discounted_cash": 326.79,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 384.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 412.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 326.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 276.52
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 377.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 317.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 317.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 367.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 367.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 315.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 279.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 384.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 384.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 315.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 279.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 327.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 317.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 440.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 279.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 279.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 416.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 412.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 326.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 427.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 276.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 315.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 427.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 384.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 315.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 276.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 412.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 315.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 412.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 276.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 367.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 384.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 276.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 412.26
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 427.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 367.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 384.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 315.73
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 331.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 367.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 377.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 367.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 317.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 315.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 406.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 326.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 416.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 412.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 412.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 315.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 427.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 440.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 315.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 377.07
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 427.35
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 427.35
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 137.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 326.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 315.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 276.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 315.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 315.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 412.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 327.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 327.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 317.74
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 442.43
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 427.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 427.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 427.35
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 427.35
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 427.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 317.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 276.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 502.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 317.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 315.73
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 502.76,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 327.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 327.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 427.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 322.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 416.79
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 326.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 317.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 406.73
            }
          ]
        }
      ]
    },
    {
      "description": "LEAD 50CM TRIAL PERC NEVRO",
      "code_information": [
        {
          "code": "SUP-TLEAD1058-50B",
          "type": "CDM"
        },
        {
          "code": "C1897",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1500,
          "discounted_cash": 975,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 982.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 982.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1230
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 982.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1125
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 982.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1230
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1125
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 976.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1125
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 832.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 825
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1230
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1213.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1095
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1243.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1230
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 328.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 825
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1146
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 825
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 832.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1320
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1500
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1315.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1095
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1095
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 832.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 976.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1146
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1095
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 982.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1146
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1146
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 825
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 976.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 958.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 825
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 825
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 958.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 958.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 975
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 825
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 832.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1230
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1243.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1230
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1213.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 409.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 982.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1095
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1243.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 976.5
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 990
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 982.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 982.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 958.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1230
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 976.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1315.5
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1146
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1146
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1095
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1230
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "KIT 50CM LEAD PERC NEVRO",
      "code_information": [
        {
          "code": "SUP-LEAD1058-50B",
          "type": "CDM"
        },
        {
          "code": "C1778",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1500,
          "discounted_cash": 975,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1230
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 958.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 976.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1125
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1230
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1315.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1315.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 982.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 832.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 825
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1230
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1230
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 982.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1125
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1095
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1095
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 976.5
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1125
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1230
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 958.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 825
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1146
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 990
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 328.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 409.5
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 825
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1230
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1213.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1095
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1500
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1243.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 958.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 825
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 832.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1243.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1230
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 982.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 982.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 982.5
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1320
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1230
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 982.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1095
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 976.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 982.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1146
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1243.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1213.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 832.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 976.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1146
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 975
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1095
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1275
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 825
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 915
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 976.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 832.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 982.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1146
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 825
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 825
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 961.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1146
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1146
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 958.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1095
            }
          ]
        }
      ]
    },
    {
      "description": "KIT REMOTE PATIENT NEVRO",
      "code_information": [
        {
          "code": "SUP-PTRC1000",
          "type": "CDM"
        },
        {
          "code": "C1787",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3069,
          "discounted_cash": 1994.85,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1970.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2608.65
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2544.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1927.33
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1939.61
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 672.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1970.3
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2608.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1703.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1703.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1997.92
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1994.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1970.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2482.82
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2691.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1939.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1927.33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2608.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1687.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1687.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2608.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2344.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2240.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2516.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3069
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2516.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1927.33
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2240.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1939.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1687.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1997.92
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2608.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1970.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2240.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2240.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1687.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1970.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1927.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1687.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2301.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1991.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1703.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2516.58
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2025.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2240.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2516.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1991.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1927.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1939.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2691.51
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2700.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1927.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2344.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2344.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1991.78
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2240.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1927.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1927.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1927.33
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1970.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1687.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2544.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1939.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1939.61
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2608.65
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1997.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2344.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1970.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2344.72
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2608.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2608.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1997.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1991.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1970.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1927.33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1970.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1703.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2544.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2608.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1970.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1927.33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2608.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1927.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1687.95
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 837.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1939.61
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2301.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2344.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2608.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1927.33
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2516.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2516.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1939.61
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2608.65
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2516.58
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2608.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1970.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1970.3
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2301.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2516.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1997.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2482.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2608.65
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3069,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "CATH SWAN NECK 2 CUFF LEFT 62CM PD",
      "code_information": [
        {
          "code": "SUP-8888413401",
          "type": "CDM"
        },
        {
          "code": "C1750",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 694.08,
          "discounted_cash": 451.15,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 445.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 445.6
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 438.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 506.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 506.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 575.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 569.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 569.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 438.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 569.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 451.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 381.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 530.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 561.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 589.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 381.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 438.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 451.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 381.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 385.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 530.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 575.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 451.85
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 561.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 381.74
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 575.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 445.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 589.97
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 589.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 589.97
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 589.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 569.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 438.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 608.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 589.97
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 445.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 445.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 569.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 569.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 451.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 530.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 438.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 506.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 451.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 445.6
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 589.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 506.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 506.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 569.15
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 189.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 381.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 438.66
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 451.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 385.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 385.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 694.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 569.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 520.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 445.6
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 438.66
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 589.97
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 381.74
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 530.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 608.71
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 589.97
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 445.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 520.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 506.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 385.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 445.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 520.56
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 589.97
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 589.97
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 445.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 589.97
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 530.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 530.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 445.6
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 458.09
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 589.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 438.66
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 610.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 445.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 381.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 589.97
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 694.08,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 3.5 X 16MM CORTEX LOW PRO SELF-TAP STRDRV",
      "code_information": [
        {
          "code": "SUP-02.206.216",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 89.04,
          "discounted_cash": 57.88,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 68.03
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 58.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 56.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.01
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 56.9
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 54.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 58.32
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 54.31
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 54.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 49.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 72.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 54.31
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 78.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 66.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 56.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.97
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 54.31
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 68.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 54.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 68.03
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 58.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 54.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 54.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 58.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.68
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.68
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 66.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.01
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 54.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 68.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 54.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.68
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 58.32
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 73.81
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 73.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.01
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 57.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 78.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 49.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 58.32
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 58.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 78.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 56.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 68.03
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 72.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 49.42
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.68
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 89.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 73.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 68.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 73.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 54.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 49.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 57.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 58.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 66.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 54.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 57.07
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 58.32
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 54.31
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 89.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.97
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 24.31
            }
          ]
        }
      ]
    },
    {
      "description": "CLAMP PIN LG 4-POSITION MR SAFE EX-FIX",
      "code_information": [
        {
          "code": "SUP-390.009",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1084.5,
          "discounted_cash": 704.92,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 828.56
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 921.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 681.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 889.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 706.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 921.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 596.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 696.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 696.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 596.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 951.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 681.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 696.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 601.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 889.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 681.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 681.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 921.83
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 921.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 696.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 685.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 685.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 877.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 706.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 685.4
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 715.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 601.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 889.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 681.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 596.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 889.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 877.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 681.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 681.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 685.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 696.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1084.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 596.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 791.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 601.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 681.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 791.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 596.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 681.07
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 921.83
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 921.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 899.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 696.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 828.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 921.83
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 921.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 889.29
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 954.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 681.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 685.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 828.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 703.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 921.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 706.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 791.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1084.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 889.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 706.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 596.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 813.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 921.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 706.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 696.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 696.25
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 296.07
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 704.93
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 921.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 596.48
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 813.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 696.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 828.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 899.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 685.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 813.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 791.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 681.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 685.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 791.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 889.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 828.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 703.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 921.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 791.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 889.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 681.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 703.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 601.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 899.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 685.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 828.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 696.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 703.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 681.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 951.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 696.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 696.25
            }
          ]
        }
      ]
    },
    {
      "description": "COMPONENT SZ4 LT NARROW CR OXINIUM LEGION",
      "code_information": [
        {
          "code": "SUP-71421244",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6150,
          "discounted_cash": 3997.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3942.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5393.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3751.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1107
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3751.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5227.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4489.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3751.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3382.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3382.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5227.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3942.15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3942.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4698.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5227.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4028.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3751.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4698.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5227.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4698.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4698.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3942.15
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5227.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1678.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4003.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4003.65
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5098.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4028.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5227.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3929.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5043
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4003.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3942.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3942.15
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3942.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5227.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3751.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3751.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4028.25
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5412
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3751.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3751.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3942.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5227.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3382.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4489.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4975.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4612.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3751.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3413.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6150
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4028.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5043
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3751.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5227.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4028.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4028.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4028.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4028.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3929.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3382.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4612.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3751.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3929.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5043
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4003.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3413.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5043
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5043
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3751.5
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1346.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3942.15
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4059
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3929.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4489.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5043
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5227.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5227.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3942.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5227.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5227.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3413.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5043
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3942.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3751.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3997.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5098.35
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5393.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5043
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4975.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4489.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3382.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3382.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5227.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3413.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4698.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3942.15
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5098.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4612.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1107
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4489.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4003.65
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6150,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4698.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3382.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4489.5
            }
          ]
        }
      ]
    },
    {
      "description": "CARTRIDGE 30MM RELOAD MED CVD TIP TAN",
      "code_information": [
        {
          "code": "SUP-SIG30CTAVM",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1606.76,
          "discounted_cash": 1044.39,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1042.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 883.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1015.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1205.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1009.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1015.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1042.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1317.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1299.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.54
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 438.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1046
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1015.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1015.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1332
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1317.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1317.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1227.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1009.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1009.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.75
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1044.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1227.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1042.79
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1413.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1606.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1015.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1172.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1009.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 883.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1409.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1009.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1227.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 891.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1015.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1172.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1332
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1317.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1409.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1009.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 883.72
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1332
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1317.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1317.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1046
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1606.76,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1060.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.75
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1172.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 883.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 891.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 883.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1046
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1046
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 883.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1205.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1172.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1009.05
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1205.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1046
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1227.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1009.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 891.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1009.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 883.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1031.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1042.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1015.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 891.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1317.54
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1172.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1227.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1009.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1009.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1015.47
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1365.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1299.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1227.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1172.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1009.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1009.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1317.54
            }
          ]
        }
      ]
    },
    {
      "description": "SNARE POLYPECTOMY MICRO-OVAL CAPTIFLEX 10/BX",
      "code_information": [
        {
          "code": "SUP-6242",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 39.45,
          "discounted_cash": 25.64,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 21.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.35
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 21.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 21.89
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 34.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 25.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 25.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.14
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.93
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.14
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 25.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 31.92
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 26.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 25.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 25.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 34.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.77
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 39.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 10.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 34.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 21.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 31.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 24.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.35
            }
          ]
        }
      ]
    },
    {
      "description": "HANDPIECE 18CM LIGASURE IMPACT",
      "code_information": [
        {
          "code": "SUP-LF4418",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1314.38,
          "discounted_cash": 854.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1004.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1077.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 855.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 722.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 855.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1077.79
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 358.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 722.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 722.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 843.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1077.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 985.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 825.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 830.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1077.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 959.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1117.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 722.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 843.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1117.22
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 867.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 825.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 959.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1077.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 825.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1089.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 830.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 825.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 825.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1117.22
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1117.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 722.91
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1117.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 843.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 843.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1089.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 855.66
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 854.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 830.69
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1117.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 959.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 843.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1004.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 843.83
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1117.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 853.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 830.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 843.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 825.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 853.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 855.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 825.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1077.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 830.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 825.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 729.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 729.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 729.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1004.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1004.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1004.19
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1314.38,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 722.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 722.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 959.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1077.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 825.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 825.43
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 985.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 853.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1063.33
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1117.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 830.69
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1117.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 825.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 830.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 843.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 843.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1314.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1152.71
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1117.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 843.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 843.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 985.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 825.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 959.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1117.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 853.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1077.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1063.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 830.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1004.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 855.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1152.71
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1156.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 843.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 959.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 729.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 825.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1117.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1089.62
            }
          ]
        }
      ]
    },
    {
      "description": "CUFF 8MM FOME TRACH",
      "code_information": [
        {
          "code": "SUP-850180",
          "type": "CDM"
        },
        {
          "code": "C1769",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 307.17,
          "discounted_cash": 199.66,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 197.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 199.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 194.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 194.13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 261.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 251.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 234.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 251.88
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 83.86
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 261.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 197.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 168.94
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 251.88
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 261.09
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 230.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 269.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 199.97
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 261.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 261.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 251.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 248.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 194.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 197.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 170.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 261.09
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 194.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 197.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 197.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 194.13
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 230.38
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 261.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 224.23
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 224.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 170.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 254.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 251.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 168.94
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 261.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 197.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 230.38
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 197.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 224.23
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 197.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 194.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 168.94
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 234.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 197.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 234.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 168.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 254.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 234.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 261.09
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 234.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 261.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 261.09
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 261.09
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 261.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 197.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 234.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 194.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 254.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 251.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 170.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 199.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 194.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 168.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 168.94
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 261.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 170.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 251.88
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 224.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 224.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 224.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 251.88
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 270.31
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 197.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 197.2
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 202.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 307.17
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 199.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 269.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 307.17,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 199.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 199.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 248.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 168.94
            }
          ]
        }
      ]
    },
    {
      "description": "GUIDE PIN 3 X 75MM SS ASCEND",
      "code_information": [
        {
          "code": "SUP-9722908",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 291,
          "discounted_cash": 189.15,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 222.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 247.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 212.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 291
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 160.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 212.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 160.05
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 79.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 189.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 161.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.82
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 247.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 161.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 189.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 160.05
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 247.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 212.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 212.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 212.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 222.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 222.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.91
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 218.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 189.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 222.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 247.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 241.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 212.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 255.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 160.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 161.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 247.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 222.32
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 218.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 189.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 241.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 188.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 247.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 160.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 218.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 247.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 241.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 238.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 255.21
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 256.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 188.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 188.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 188.86
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 291,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 235.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 222.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.91
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 247.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 235.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 182.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 247.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 247.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 161.51
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 247.35
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 192.06
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 247.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 186.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 183.91
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 189.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 189.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 160.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 160.05
            }
          ]
        }
      ]
    },
    {
      "description": "INSERT 6 X 36MM A-12.5 HUM REVERSED ASCEND FLEX",
      "code_information": [
        {
          "code": "SUP-DWF361B",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2853,
          "discounted_cash": 1854.45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1828.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1828.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1828.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2308.08
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1857.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1569.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2339.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2339.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1828.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1823.07
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 778.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1868.72
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2510.64
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2425.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1828.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2082.69
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2425.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2139.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1868.72
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2425.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1740.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2082.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1857.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1740.33
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2365.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2502.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1828.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2425.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2425.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1868.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1857.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1740.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1740.33
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1583.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1868.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1740.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1740.33
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2425.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2179.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2425.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1868.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1828.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2425.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1569.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2365.14
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2139.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2502.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2179.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2179.69
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1868.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2853
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1583.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2365.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1828.77
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2425.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1857.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1740.33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1569.15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1740.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1740.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1828.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1868.72
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1882.98
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1583.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1569.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1828.77
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1823.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1740.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1569.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1740.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1857.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2308.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1828.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2082.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2339.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1569.15
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 624.81
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2425.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1583.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2339.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2139.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2425.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1569.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2082.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2082.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2082.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2339.46
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1854.45
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2425.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2179.69
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2425.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2339.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2339.46
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1740.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1740.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2179.69
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1828.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2179.69
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2425.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2339.46
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1868.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1823.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1823.07
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2853,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "MESH 11CM RESORBABLE PHASIX ST",
      "code_information": [
        {
          "code": "SUP-1200011",
          "type": "CDM"
        },
        {
          "code": "C1781",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6874.2,
          "discounted_cash": 4468.23,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5251.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5251.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6028.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5018.17
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1237.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4392.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3815.18
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5843.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5698.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4475.1
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4193.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3780.81
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4406.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5018.17
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4406.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4406.36
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5636.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5843.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3780.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4193.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5251.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5018.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5636.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4406.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4406.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3780.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5018.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6874.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4502.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5698.71
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4502.6
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4502.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4502.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4502.6
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6049.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4406.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3780.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4502.6
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5843.07
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1237.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5018.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5636.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4475.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5561.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3780.81
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4468.23
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5843.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4193.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4193.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5843.07
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4502.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5636.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5636.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5636.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4475.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4475.1
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4536.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3815.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3815.18
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4406.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4193.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5843.07
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5843.07
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3780.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4502.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4406.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5251.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5251.89
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5155.65
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6028.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4193.26
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5636.84
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1505.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5018.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4193.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4406.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4406.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4392.61
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5843.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4193.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5251.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4193.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4193.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4193.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3815.18
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4406.36
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5843.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3780.81
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4392.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5561.23
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5843.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4193.26
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5155.65
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4193.26
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5843.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4406.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4392.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5636.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4475.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5698.71
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1876.66
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5843.07
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6874.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5843.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5843.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5155.65
            }
          ]
        }
      ]
    },
    {
      "description": "DEVICE SUCTION BIOVAC",
      "code_information": [
        {
          "code": "SUP-00711512",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 388.8,
          "discounted_cash": 252.72,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 249.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 340.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 245.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 215.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 253.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 330.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 244.17
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 330.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 322.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 322.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 297.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 249.61
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 330.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 283.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 249.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 297.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 318.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 253.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 213.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 297.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 245.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 297.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 283.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 245.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 249.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 249.61
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 330.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 249.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 388.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 330.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 213.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 244.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 330.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 213.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 283.82
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 330.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 244.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 244.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 215.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 245.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 249.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 244.17
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 388.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 318.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 244.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 252.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 245.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 297.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 249.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 253.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 245.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 244.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 252.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 213.84
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 106.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 245.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 252.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 330.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 283.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 318.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 283.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 244.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 213.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 213.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 318.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 291.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 249.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 249.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 253.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 318.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 252.33
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 330.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 330.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 215.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 322.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 244.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 244.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 244.17
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 330.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 318.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 244.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 244.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 330.48
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 342.14
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 256.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 297.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 213.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 340.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 253.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 314.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 283.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 215.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 318.82
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 252.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 291.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 291.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 249.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 314.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 245.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 318.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 249.61
            }
          ]
        }
      ]
    },
    {
      "description": "DILATOR 15-18MM WIREGUIDE CRE",
      "code_information": [
        {
          "code": "SUP-5849",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 585,
          "discounted_cash": 380.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 375.57
            },
            {
              "payer_name": "MMO [485]",
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            },
            {
              "payer_name": "GREATWEST [550]",
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              "standard_charge_percentage": 82.9,
              "estimated_amount": 484.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "standard_charge_percentage": 82,
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            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 367.38
            },
            {
              "payer_name": "FLORA [411]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 497.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 497.25
            },
            {
              "payer_name": "AETNA [310]",
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            {
              "payer_name": "HEALTHLINK [443]",
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              "standard_charge_percentage": 75,
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            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
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            },
            {
              "payer_name": "OSU [553]",
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            },
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              "payer_name": "UHC [625]",
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              "estimated_amount": 367.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 321.75
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 375.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
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              "standard_charge_percentage": 82.9,
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            },
            {
              "payer_name": "PARAMOUNT [555]",
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              "standard_charge_percentage": 85,
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            },
            {
              "payer_name": "EMERALD [395]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 497.25
            },
            {
              "payer_name": "UHC [625]",
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              "estimated_amount": 379.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
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            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 63.2,
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            },
            {
              "payer_name": "SEORMC [545]",
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              "standard_charge_percentage": 66,
              "estimated_amount": 386.1
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
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            },
            {
              "payer_name": "UHC [625]",
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            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 321.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 321.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 479.7
            },
            {
              "payer_name": "MMO [485]",
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              "estimated_amount": 513.05
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 375.57
            },
            {
              "payer_name": "ANTHEM [335]",
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              "standard_charge_percentage": 55.5,
              "estimated_amount": 324.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
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            },
            {
              "payer_name": "AETNA [310]",
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            },
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              "payer_name": "MMO [485]",
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              "estimated_amount": 369.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 497.25
            },
            {
              "payer_name": "UHC [625]",
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              "estimated_amount": 367.38
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            {
              "payer_name": "AETNA [310]",
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              "estimated_amount": 375.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 497.25
            },
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              "payer_name": "OSU [553]",
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            },
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              "payer_name": "ANTHEM [335]",
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            },
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              "payer_name": "CIGNA [370]",
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            },
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            },
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              "payer_name": "UHC [625]",
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            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 367.38
            },
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              "payer_name": "HEALTHREACH [540]",
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            },
            {
              "payer_name": "IHG [492]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 497.25
            },
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              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 427.05
            },
            {
              "payer_name": "GREATWEST [550]",
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              "standard_charge_percentage": 82.9,
              "estimated_amount": 484.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 479.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 479.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 369.72
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 427.05
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 367.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
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              "standard_charge_percentage": 75,
              "estimated_amount": 438.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 369.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 369.72
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 497.25
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 375.57
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 497.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 379.67
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 369.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
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              "standard_charge_percentage": 100,
              "estimated_amount": 585
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 479.7
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 446.94
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 367.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 479.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 380.84
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 380.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 497.25
            },
            {
              "payer_name": "UHC [625]",
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              "estimated_amount": 367.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 367.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "estimated_amount": 479.7
            },
            {
              "payer_name": "CIGNA [370]",
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              "estimated_amount": 380.84
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
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              "standard_charge_percentage": 27.3,
              "estimated_amount": 159.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 369.72
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 446.94
            },
            {
              "payer_name": "HEALTHLINK [443]",
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              "standard_charge_percentage": 75,
              "estimated_amount": 438.75
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 80.9,
              "estimated_amount": 473.27
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 367.38
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 427.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 446.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 446.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 479.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 380.84
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 375.57
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 380.25
            },
            {
              "payer_name": "AETNA [310]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 375.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 321.75
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 380.84
            },
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              "payer_name": "ANTHEM [335]",
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              "standard_charge_percentage": 55.5,
              "estimated_amount": 324.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
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              "standard_charge_percentage": 87.7,
              "estimated_amount": 513.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 379.67
            },
            {
              "payer_name": "AETNA [310]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 375.57
            },
            {
              "payer_name": "AETNA [310]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 446.94
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 514.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 375.57
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 497.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 367.38
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 497.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 324.68
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 585,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 446.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 367.38
            }
          ]
        }
      ]
    },
    {
      "description": "DILATOR 18-20MM FIXED WIRE CRE 5838",
      "code_information": [
        {
          "code": "SUP-5838",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 504,
          "discounted_cash": 327.6,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 385.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 323.57
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 428.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 318.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 413.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 323.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 328.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 316.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 277.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 279.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 323.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 323.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 367.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 367.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 378
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 279.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 413.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 316.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 316.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 277.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 318.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 413.28
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 332.64
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 504,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 413.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 413.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 327.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 327.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 327.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 428.4
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 137.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 318.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 442.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 279.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 279.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 413.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 327.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 323.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 323.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 323.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 316.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 277.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 428.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 316.51
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 428.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 323.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 316.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 328.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 316.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 318.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 323.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 428.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 277.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 323.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 318.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 428.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 417.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 413.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 318.53
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 428.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 328.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 367.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 328.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 385.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 385.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 428.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 442.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 327.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 417.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 323.57
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 428.4
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 428.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 316.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 316.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 385.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 316.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 407.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 385.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 318.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 316.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 316.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 328.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 318.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 428.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 316.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 428.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 277.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 504
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 417.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 413.28
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 443.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 277.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 323.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 385.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 367.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 407.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 378
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 367.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 367.92
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 378
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 277.2
            }
          ]
        }
      ]
    },
    {
      "description": "GUIDEWIRE 2MM SM F/ 4.5/8.5MM BEAMING SYS DISP",
      "code_information": [
        {
          "code": "SUP-130-00020",
          "type": "CDM"
        },
        {
          "code": "C1769",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 36.33,
          "discounted_cash": 23.61,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.52
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.76
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 36.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 29.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31.86
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.88
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.88
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31.86
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.88
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 23.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.16
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.52
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.88
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 30.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 29.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.88
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 30.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 31.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.76
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.52
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 30.12
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.76
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.32
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.79
            }
          ]
        }
      ]
    },
    {
      "description": "PLATE 194MM 8HL LT LCP EXTRA ARTIC DISTAL HUMERUS STERL",
      "code_information": [
        {
          "code": "SUP-02.104.028S",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3385.5,
          "discounted_cash": 2200.57,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2170.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2586.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2170.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2586.52
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2471.42
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2217.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2877.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2065.16
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2877.68
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2065.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2065.16
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2170.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2969.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2877.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1878.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2738.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2065.16
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2065.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2170.11
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2877.68
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2234.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2471.42
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2065.16
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2877.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1862.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2163.33
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2539.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1862.03
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2203.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2586.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2203.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2065.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2217.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2217.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2065.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2539.13
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2877.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2877.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1862.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2776.11
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2877.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2203.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2065.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2217.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2877.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2217.5
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2979.24
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2217.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2170.11
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2539.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1862.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2471.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2738.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2776.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2065.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1862.03
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2217.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3385.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2471.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1878.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2776.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2170.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2065.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2170.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2776.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2776.11
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2163.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1862.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2586.52
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2877.68
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2877.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2170.11
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1878.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1862.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2586.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2170.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2163.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2806.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2776.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2776.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2065.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2586.52
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2200.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2170.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2776.11
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2806.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2806.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2203.96
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 924.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2969.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2163.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2471.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2203.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2170.11
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3385.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2471.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1878.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2170.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2217.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2877.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2877.68
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 741.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2065.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2877.68
            }
          ]
        }
      ]
    },
    {
      "description": "PLATE 6HL HEAD 7HL SHAFT RT VAR ANG STD LCP DSTL RAD STERL",
      "code_information": [
        {
          "code": "SUP-02.111.670S",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6826.32,
          "discounted_cash": 4437.11,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5215.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4375.67
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5802.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3788.61
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3754.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5986.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4164.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4164.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4375.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5659.02
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5802.37
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4505.37
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5802.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5215.31
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4443.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4164.06
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5802.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4164.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4362.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5802.37
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4983.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4443.93
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1863.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5802.37
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4983.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5215.31
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3788.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4471.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4471.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5215.31
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5119.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4164.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4443.93
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5802.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4375.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4164.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5659.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4471.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4362.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3788.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3788.61
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4375.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4164.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4983.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4375.67
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5597.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5802.37
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4437.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4375.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5802.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5802.37
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1228.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3754.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3754.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5597.58
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3754.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4471.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4375.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4375.67
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5119.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3754.48
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6007.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5522.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4443.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4375.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5802.37
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5986.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4164.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4983.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4983.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4164.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6826.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4443.93
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5802.37
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5215.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5215.31
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1494.96
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3754.48
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5659.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5597.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4164.06
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4164.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4362.02
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5802.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5119.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4375.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4375.67
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1228.74
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5802.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4983.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5522.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4471.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4164.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5597.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5597.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4164.06
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3754.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5597.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4471.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4375.67
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6826.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4471.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5597.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5597.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4471.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4362.02
            }
          ]
        }
      ]
    },
    {
      "description": "USE ITM-40182257 HEMOSTAT 2 X 14IN SURGICEL 1951",
      "code_information": [
        {
          "code": "SUP-1951",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 259.45,
          "discounted_cash": 168.64,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 166.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 198.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 212.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 163.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 143.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 212.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 168.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 168.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 198.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 166.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 220.53
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 220.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 142.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 166.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 189.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 163.97
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 220.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 209.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 142.7
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 259.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 194.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 212.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 227.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 168.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 189.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 215.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 166.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 166.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 163.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 163.97
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 220.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 212.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 212.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.93
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 220.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 220.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 198.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 189.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 215.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 212.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 209.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 168.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 194.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 166.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 168.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 220.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 189.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 215.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.93
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 70.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 163.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 212.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 168.9
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 171.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 220.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 168.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 166.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 142.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 143.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 143.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 198.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 198.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 189.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 220.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 166.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 189.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 227.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 166.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 220.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 220.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 168.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 166.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 168.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 194.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 143.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 163.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 142.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 166.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 198.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 142.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 168.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 163.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 166.57
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 220.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 142.7
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 228.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 142.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 162.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 259.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 212.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 163.97
            }
          ]
        }
      ]
    },
    {
      "description": "RING 180MM FULL CARBON FIBER MR CONDITIONAL",
      "code_information": [
        {
          "code": "SUP-03.311.848",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2892,
          "discounted_cash": 1879.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2209.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1856.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1827.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1590.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1590.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2111.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1816.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2339.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1856.66
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2458.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2458.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2458.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1856.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1856.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1605.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2371.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1882.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1882.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1827.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2209.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1816.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1816.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1816.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1816.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1827.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2209.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2169
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1827.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1590.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2371.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2371.44
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2544.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1856.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2371.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1882.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1590.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1882.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2209.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1816.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1816.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2111.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1876.91
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2169
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2458.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2169
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1590.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2458.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1605.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2371.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2209.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2458.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1879.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2892,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 789.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1856.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1876.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1816.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1816.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2371.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1827.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1816.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1816.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1590.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1856.66
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1908.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2536.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1876.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2339.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2371.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1816.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2458.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2111.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2397.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1882.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1827.74
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2458.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1827.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1856.66
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2458.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1605.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2536.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1876.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2458.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2892
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1856.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1856.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1605.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2111.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2111.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1827.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1816.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2458.2
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2458.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1590.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2209.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1856.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2371.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2397.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1856.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2111.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2397.47
            }
          ]
        }
      ]
    },
    {
      "description": "GUIDEWIRE 2.8 X 350 TROCAR PT SS",
      "code_information": [
        {
          "code": "SUP-357039",
          "type": "CDM"
        },
        {
          "code": "C1769",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 112.5,
          "discounted_cash": 73.12,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 92.25
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 72.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 72.23
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 92.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 72.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 72.23
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 98.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 92.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 72.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 92.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 62.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 92.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 73.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 112.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 72.23
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 62.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 72.23
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 84.38
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 82.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 72.23
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 74.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 71.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.88
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 92.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 73.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 91.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.88
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 84.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 82.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 62.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 92.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 72.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 84.38
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 82.13
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 73.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 82.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 62.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 82.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 93.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 91.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 72.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 72.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 92.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 98.66
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 93.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 73.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 73.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 72.23
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 93.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 82.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 73.13
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 112.5,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "GUIDEWIRE 13.5/3.2MM FOR IM NAIL",
      "code_information": [
        {
          "code": "SUP-360267",
          "type": "CDM"
        },
        {
          "code": "C1769",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 899.64,
          "discounted_cash": 584.77,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 687.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 687.32
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 764.69
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 568.57
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 499.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 727.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 494.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 737.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 899.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 674.73
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 764.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 494.8
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 584.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 737.7
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 494.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 568.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 499.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 727.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 577.57
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 764.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 764.69
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 593.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 656.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 585.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 568.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 577.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 577.57
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 687.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 577.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 656.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 494.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 494.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 764.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 499.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 585.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 687.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 764.69
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 568.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 568.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 737.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 577.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 577.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 674.73
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 764.69
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 674.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 788.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 656.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 585.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 788.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 577.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 568.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 737.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 577.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 764.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 745.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 764.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 687.32
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 791.68
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 577.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 656.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 656.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 568.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 577.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 764.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 745.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 568.57
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 585.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 499.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 737.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 764.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 687.32
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 577.57
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 764.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 737.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 737.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 585.67
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 764.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 577.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 656.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 737.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 245.6
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 764.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 745.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 494.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 899.64,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 494.8
            }
          ]
        }
      ]
    },
    {
      "description": "DISTRACTOR SM EX FIX",
      "code_information": [
        {
          "code": "SUP-394.06",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2259,
          "discounted_cash": 1468.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1450.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1725.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2259
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1987.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1649.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1450.28
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1920.15
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1920.15
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1490.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1418.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1418.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1450.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1470.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1427.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1427.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1427.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1427.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1418.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1468.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1418.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1450.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1852.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1649.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1852.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1450.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1920.15
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 616.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1427.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1852.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1920.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1470.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1427.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1253.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1981.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1725.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1242.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1466.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1253.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1242.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1827.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1242.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1920.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1649.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1649.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1872.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1852.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1450.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1253.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1418.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1418.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1466.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1427.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1981.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1450.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1242.45
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1920.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1470.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1872.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1470.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1725.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1827.53
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1920.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1852.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1418.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1649.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1418.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1450.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1725.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1450.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1920.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1418.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1242.45
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1920.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1694.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1470.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1418.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1242.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1852.38
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1920.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1450.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1694.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1920.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1418.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1418.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1242.45
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1694.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1427.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1450.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1450.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1725.88
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2259,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1649.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1725.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1852.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1872.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1852.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1418.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1466.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1253.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1466.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1920.15
            }
          ]
        }
      ]
    },
    {
      "description": "ELECTRODE ROLLER BAR 24/26FR",
      "code_information": [
        {
          "code": "SUP-RB",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 326.3,
          "discounted_cash": 212.09,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 249.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 286.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 326.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 211.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 204.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 238.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 238.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 204.92
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 209.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 238.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 209.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 209.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 212.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 211.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 204.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 179.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 206.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 204.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 267.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 267.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 249.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 179.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 238.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 206.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 270.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 204.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 249.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 267.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 267.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 212.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 206.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 249.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 204.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 181.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 267.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 244.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 244.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 286.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 206.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 204.92
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 204.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 204.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 204.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 267.57
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 206.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 270.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 212.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 181.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 181.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 212.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 206.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 206.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 249.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 209.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 179.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 181.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 212.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 179.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 209.48
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 179.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 238.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 206.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 267.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 263.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 209.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 209.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 209.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 209.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.36
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 89.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 212.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 263.98
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.36
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 287.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 204.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 211.77
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 244.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 249.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 209.48
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 326.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.36
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 179.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 204.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 238.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 179.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 209.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 209.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 277.36
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 215.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 204.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 270.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 267.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 211.77
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 100MM FEN HELICAL TI STERL TFNA",
      "code_information": [
        {
          "code": "SUP-04.038.200S",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1935,
          "discounted_cash": 1257.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1240.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1267.43
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1267.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1697
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1267.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1064.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1586.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1240.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1267.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1240.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1644.75
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1644.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1586.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1180.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1586.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1259.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1565.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1180.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1180.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1586.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1064.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1644.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1935
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1240.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1180.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1180.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1644.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1064.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1451.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1644.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1236.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1240.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1240.34
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1478.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1478.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1180.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1267.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1644.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1604.12
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1259.69
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1604.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1259.69
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1702.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1240.34
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1412.55
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1451.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1451.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1586.7
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1644.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1064.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1412.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1236.47
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 528.26
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1257.75
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1180.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1064.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1586.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1644.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1240.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1478.34
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1412.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1073.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1259.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1240.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1240.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1180.35
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1064.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1180.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1240.34
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1412.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1267.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1180.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1180.35
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1412.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1586.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1180.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1644.75
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1259.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1644.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1644.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1240.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1697
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1267.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1644.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1644.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1412.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1073.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1586.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1267.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1478.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1236.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1064.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1073.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1604.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1565.42
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 423.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1180.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1478.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1236.47
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1644.75
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1277.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1073.93
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1478.34
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1935,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "BIT 7MM DRILL CANN DISP DYNANAIL",
      "code_information": [
        {
          "code": "SUP-2200-05-0070",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1432.8,
          "discounted_cash": 931.32,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1174.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 905.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 795.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 899.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1174.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1174.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1159.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 899.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 929.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1432.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 905.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1045.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 899.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 899.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 929.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 788.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1094.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1094.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 932.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1187.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1256.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 929.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 795.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 932.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1094.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 899.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1174.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 905.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.86
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1432.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 905.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.88
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1074.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1074.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1094.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 899.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 788.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1187.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 932.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1045.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 795.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 795.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1187.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1045.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 899.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 905.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 899.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1174.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1174.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1256.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 788.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 788.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1045.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 788.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 932.75
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 899.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1074.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1045.94
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.86
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1260.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 899.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 788.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.88
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 945.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 788.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 905.53
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 391.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 905.53
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1094.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 932.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 905.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1094.66
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1217.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 929.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1174.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 931.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 899.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 899.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 919.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 899.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1159.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1045.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1174.9
            }
          ]
        }
      ]
    },
    {
      "description": "SUTURE 6-0 ETHILON 1856G PC-1",
      "code_information": [
        {
          "code": "SUP-1856G",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.57,
          "discounted_cash": 6.87,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.57,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.98
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.27
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.98
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.68
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.55
            }
          ]
        }
      ]
    },
    {
      "description": "FEMORAL D RT ROTATING HINGE NEXGEN",
      "code_information": [
        {
          "code": "SUP-00-5880-014-02",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 26536.29,
          "discounted_cash": 17248.59,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 17009.76
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22555.85
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22555.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19371.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14727.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 16187.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 23272.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22555.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 21467.86
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22555.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22555.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20273.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20273.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21759.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 17381.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 17009.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21759.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 16187.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22555.85
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 17275.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 17275.12
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19371.49
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21759.76
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 16956.69
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 5811.45
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22555.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 17275.12
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 17381.27
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14727.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 17009.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 16956.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 16187.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14594.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 17009.76
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 7244.41
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 23351.94
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22555.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 17381.27
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 4776.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14727.64
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21759.76
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19371.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14594.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22555.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14594.96
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21759.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 16187.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20273.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 16187.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 16187.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22555.85
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 21998.58
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 17248.59
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 19902.22
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 17381.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 17381.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 17381.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 17009.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 17009.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20273.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 19902.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 16187.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21759.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 17009.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14594.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21759.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 16956.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 16187.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 16187.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14594.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 17009.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20273.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 17381.27
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22555.85
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 23272.33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 17381.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19371.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 21759.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 21467.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 17275.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 16956.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 19902.22
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 26536.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20273.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 16187.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19371.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19371.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 17275.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 17009.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 17009.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22555.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22555.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 21998.58
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 26536.29,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 16187.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 16187.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 17009.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 16187.14
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 4776.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22555.85
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 17513.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 21998.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 17009.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14727.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14594.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14594.96
            }
          ]
        }
      ]
    },
    {
      "description": "SUTURE TENSIONER/CUTTER F/ 2-0 0 FIBERWIRE SUTURE FOR KNEE",
      "code_information": [
        {
          "code": "SUP-AR5815",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 551.25,
          "discounted_cash": 358.31,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 353.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 353.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 402.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 303.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 346.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 358.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 303.19
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 485.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 303.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 353.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 353.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 402.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 305.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 456.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 468.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 421.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 346.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 346.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 456.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 452.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 445.96
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 150.49
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 468.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 468.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 358.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 353.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 402.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 305.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 452.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 452.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 358.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 348.39
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 468.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 402.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 346.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 303.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 402.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 468.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 452.03
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 363.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 353.9
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 468.56
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 468.56
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 413.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 305.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 452.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 348.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 348.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 303.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 346.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 353.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 456.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 358.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 348.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 348.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 483.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 413.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 468.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 357.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 303.19
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 468.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 353.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 357.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 358.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 353.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 353.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 421.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 421.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 346.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 346.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 402.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 346.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 421.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 468.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 303.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 305.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 452.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 353.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 348.39
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 551.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 452.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 468.56
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 468.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 348.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 357.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 421.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 413.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 346.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 421.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 551.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 445.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 346.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 357.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 346.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 346.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 452.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 348.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 483.45
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 358.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 353.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 346.19
            }
          ]
        }
      ]
    },
    {
      "description": "KIT GENERATOR PULSE IMPLANTABLE SENZA II NEVRO IPG",
      "code_information": [
        {
          "code": "SUP-NIPG2000",
          "type": "CDM"
        },
        {
          "code": "C1822",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 55500,
          "discounted_cash": 36075,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 35575.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 36352.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 36352.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 48673.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 33855
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 35575.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 30802.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 33855
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47175
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 9990
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 35575.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40515
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 33855
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47175
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47175
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 36352.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42402
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 35575.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 36352.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42402
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 35575.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 33855
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40515
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42402
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 36075
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40515
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 46009.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 44899.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 36352.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 35575.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45510
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45510
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36130.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 46009.5
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 12154.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 33855
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 33855
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30525
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 35575.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47175
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 9990
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47175
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40515
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 36630
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 33855
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47175
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30525
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42402
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47175
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 41625
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 30802.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45510
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40515
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 33855
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 15151.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 36352.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47175
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40515
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45510
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47175
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47175
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 35575.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 35575.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42402
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45510
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 41625
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 36352.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 35575.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47175
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 46009.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 35575.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 33855
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 35464.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 30802.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 30802.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 35464.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45510
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 33855
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30525
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30525
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 35575.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30525
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 36352.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47175
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36130.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47175
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 48673.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30525
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 35464.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47175
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 55500
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 44899.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45510
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36130.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45510
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 35464.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42402
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 33855
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 48840
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 55500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36130.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30525
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36130.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 41625
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 33855
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 33855
            }
          ]
        }
      ]
    },
    {
      "description": "STAPLER 28MM EEA BLUE W/ 3.5MM STAPLES SINGLE USE",
      "code_information": [
        {
          "code": "SUP-EEA2835",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2753.76,
          "discounted_cash": 1789.94,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1767.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1787.19
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1789.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1767.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1528.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2258.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1740.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1729.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2103.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1767.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1767.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2103.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1740.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1787.19
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2340.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2010.24
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 751.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1740.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2065.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2010.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1740.38
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2340.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1792.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1792.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1787.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2340.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2340.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1767.91
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2065.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2258.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2415.05
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2340.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2103.87
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2340.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1729.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1729.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2010.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2282.87
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2340.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2103.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1729.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1514.57
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2423.31
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2340.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1729.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1729.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1729.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1528.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2282.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1767.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1767.91
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2065.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1729.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2010.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2258.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1740.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2340.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1528.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1528.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1729.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2258.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1729.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1767.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1729.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2753.76,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1514.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2415.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1740.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1767.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2010.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2753.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1514.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2258.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1740.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1729.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2010.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1792.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1729.36
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1817.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1514.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2282.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1767.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1792.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2103.87
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2340.7
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2340.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1514.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2258.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2103.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1514.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2258.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2258.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2227.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1514.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1767.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1787.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1740.38
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2340.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1792.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2227.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1767.91
            }
          ]
        }
      ]
    },
    {
      "description": "FEMORAL SZ2.5 RT TC3 PFC SIGMA",
      "code_information": [
        {
          "code": "SUP-960092",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 15971.85,
          "discounted_cash": 10381.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12202.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11659.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10206.01
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11978.89
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 3497.84
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 2874.93
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13240.66
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 14055.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11659.45
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9742.83
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13576.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14007.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11978.89
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4360.32
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13576.07
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 2874.93
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13576.07
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13576.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10237.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10237.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 15971.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10397.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11659.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9742.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13096.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9742.83
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 10461.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12202.49
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10397.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10237.96
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10237.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8864.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13576.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9742.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9742.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10397.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14007.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12202.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 10461.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13576.07
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13576.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8784.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11659.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8864.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9742.83
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 10461.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12202.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12202.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8784.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10397.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8784.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 10461.56
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13096.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13096.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10237.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10237.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8864.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8784.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10237.96
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13096.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13096.92
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13576.07
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8784.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10206.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10237.96
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13576.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13240.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9742.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9742.83
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13576.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13240.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12921.23
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 10541.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9742.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10206.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10237.96
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13576.07
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 10381.7
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11978.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12202.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10237.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 10461.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8784.52
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 10461.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11659.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13096.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 10461.56
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10237.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9742.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13096.92
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13576.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8864.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9742.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12921.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 10206.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9742.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8784.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 10237.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13096.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10397.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 10461.56
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13576.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 9742.83
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15971.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13576.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11659.45
            }
          ]
        }
      ]
    },
    {
      "description": "APPLIER 5MM CLIP MED/LG AUTO ENDO 5 WECK",
      "code_information": [
        {
          "code": "SUP-AE05ML",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 600,
          "discounted_cash": 390,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 458.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 497.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 492
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 330
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 379.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 458.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 438
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 492
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 389.4
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 379.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 485.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 379.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 497.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 438
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 438
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 492
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 330
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 396
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 492
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 390.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 333
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 390.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 330
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 526.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 450
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 163.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 458.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 333
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 333
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 497.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 390
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 379.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 379.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 458.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 389.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 485.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 526.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 330
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 438
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 379.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 528
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 438
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 492
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 379.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 330
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 390.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 458.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 492
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 492
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 389.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 390.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 492
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 600,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 450
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 438
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 458.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 389.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 379.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 330
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 390.6
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 450
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 600
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 333
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 330
            }
          ]
        }
      ]
    },
    {
      "description": "FORCEPS CADIERE DAVINCI S REPOS/10",
      "code_information": [
        {
          "code": "SUP-420049",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 630,
          "discounted_cash": 409.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 481.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 404.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 516.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 395.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 509.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 398.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 552.51
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 472.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 404.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 481.32
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 171.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 349.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 535.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 509.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 346.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 535.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 346.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 404.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 395.64
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 554.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 481.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 535.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 535.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 395.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 404.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 404.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 398.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 398.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 459.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 630
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 349.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 410.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 481.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 349.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 409.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 346.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 516.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 395.64
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 415.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 535.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 404.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 535.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 346.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 395.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 408.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 404.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 459.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 408.87
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 630,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 459.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 349.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 516.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 395.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 398.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 472.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 535.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 459.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 410.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 410.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 522.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 395.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 410.13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 535.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 516.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 516.6
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 535.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 516.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 516.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 408.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 459.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 410.13
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 535.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 395.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 408.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 404.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 398.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 346.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 459.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 395.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 395.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 522.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 481.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 404.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 535.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 398.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 516.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 395.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 481.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 404.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 398.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 404.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 472.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 395.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 346.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 404.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 552.51
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 535.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 398.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 395.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 346.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 522.27
            }
          ]
        }
      ]
    },
    {
      "description": "STAPLER 31MM POWERED INTRALUMINAL CVD",
      "code_information": [
        {
          "code": "SUP-CDH31P",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1118.21,
          "discounted_cash": 726.84,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 854.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 916.93
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 950.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 702.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 916.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 916.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 727.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 717.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 706.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 916.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 706.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 927
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 816.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 620.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 717.89
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 950.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 702.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 725.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 706.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 706.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 838.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 816.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 615.02
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1118.21,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 717.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 702.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 727.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 927
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 916.93
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 984.02
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 950.48
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 950.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 980.67
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 950.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1118.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 927
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 717.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 854.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 727.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 615.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 854.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 854.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 854.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 838.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 916.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 816.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 950.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 615.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 620.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 702.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 702.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 950.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 816.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 620.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 725.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 725.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 702.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 727.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 717.89
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 950.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 916.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 916.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 950.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 706.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 717.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 717.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 702.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 725.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 702.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 706.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 717.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 706.71
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 950.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 702.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 706.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 717.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 702.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 816.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 702.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 717.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 615.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 615.02
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 305.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 904.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 615.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 904.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 615.02
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 838.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 816.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 620.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 702.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 854.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 717.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 727.95
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 738.02
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 726.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 980.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 950.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 717.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 950.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 702.24
            }
          ]
        }
      ]
    },
    {
      "description": "GRANULES 5CC CHRONOS 2.8-5.6MM LG STERL TRAUMA",
      "code_information": [
        {
          "code": "SUP-710.025.97S",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 798,
          "discounted_cash": 518.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 511.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 609.67
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 678.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 582.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 486.78
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 798
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 598.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 661.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 654.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 509.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 511.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 511.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 654.36
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 438.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 678.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 609.67
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 519.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 598.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 522.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 522.69
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 678.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 511.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 654.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 678.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 678.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 511.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 486.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 519.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 519.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 582.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 654.36
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 678.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 511.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 486.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 678.3
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 678.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 582.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 582.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 442.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 522.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 511.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 661.54
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 798,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 654.36
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 609.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 609.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 661.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 486.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 519.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 522.69
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 798,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 582.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 486.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 598.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 438.9
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 798,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 654.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 486.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 486.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 511.52
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 438.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 486.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 486.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 678.3
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 217.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 522.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 438.9
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 509.92
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 678.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 438.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 699.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 442.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 654.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 654.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 486.78
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 678.3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 678.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 522.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 511.52
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 678.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 582.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 509.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 522.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 511.52
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 526.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 442.89
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 798,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 486.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 645.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 442.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 609.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 511.52
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 518.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 522.69
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 798,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 609.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 678.3
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 486.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 645.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 486.78
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 702.24
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 798,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 438.9
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 798,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 438.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 511.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 699.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 509.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 519.5
            }
          ]
        }
      ]
    },
    {
      "description": "GUIDEWIRE 1.1 X 150MM NON-THRD",
      "code_information": [
        {
          "code": "SUP-292.623",
          "type": "CDM"
        },
        {
          "code": "C1769",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 64.11,
          "discounted_cash": 41.67,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.26
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.74
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 64.11
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.52
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.26
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.52
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.26
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.57
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.15
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.8
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.52
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.49
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.74
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.16
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.26
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 56.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 56.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 41.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.15
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.98
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.57
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.49
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 42.31
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.98
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 56.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.11,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            }
          ]
        }
      ]
    },
    {
      "description": "HEAD 43MM ENDO MODULAR UNIT",
      "code_information": [
        {
          "code": "SUP-6942-5-043",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1278,
          "discounted_cash": 830.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 976.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 837.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1047.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1047.96
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 779.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1033.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.9
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1047.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 779.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 819.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 819.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 709.29
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 819.2
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 779.58
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 837.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1120.81
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1086.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1278
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 779.58
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 837.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1120.81
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1086.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 837.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1047.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 779.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 816.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 932.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 831.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 831.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1059.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 837.09
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 830.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 932.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 976.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1086.3
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 958.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 816.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 932.94
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 843.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1086.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 819.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 831.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 976.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1086.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1059.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 932.94
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1124.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 976.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 819.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1086.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1047.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1047.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 779.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 779.58
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1086.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 837.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 816.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 831.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 831.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 976.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1086.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 779.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 819.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 819.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1086.3
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 958.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1086.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 837.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1086.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.9
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1086.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1047.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 779.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 779.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 819.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 779.58
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 819.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 932.94
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 279.88
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 819.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 958.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 348.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 837.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 709.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 709.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 816.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 819.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 932.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 819.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 779.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1033.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1047.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 779.58
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1086.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 976.39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1086.3
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 709.29
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1278,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1059.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 702.9
            }
          ]
        }
      ]
    },
    {
      "description": "AXLE MRH ALL SIZES",
      "code_information": [
        {
          "code": "SUP-6481-2-120",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2484,
          "discounted_cash": 1614.6,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1592.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1592.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1627.02
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2111.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1378.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1617.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1366.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1863
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1614.6
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1813.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1378.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1515.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1592.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1592.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2111.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1515.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1617.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2111.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1813.32
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2111.4
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2185.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2059.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1515.24
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 544
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2111.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2059.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1897.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1592.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1592.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1863
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1627.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2036.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1515.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1515.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2009.56
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1515.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2111.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1378.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1515.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1627.02
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2111.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1592.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1592.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1897.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2111.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1587.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1627.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1592.24
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1897.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1617.08
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2036.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1587.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1617.08
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1366.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1627.02
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2111.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2036.88
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1639.44
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1617.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1366.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1366.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1627.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1592.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1592.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1813.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2036.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1813.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2036.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2111.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1378.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2484
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1515.24
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1515.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1515.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2009.56
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2036.88
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1515.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2178.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1592.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1863
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 678.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2059.24
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1515.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2111.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1515.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2178.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1627.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1366.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2111.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2036.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1897.78
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1813.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1627.02
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2111.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1366.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1897.78
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2111.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1897.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2036.88
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1587.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1587.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1366.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1813.32
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2484,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "IMPLANT 1CC COAPTITE SYRINGE",
      "code_information": [
        {
          "code": "SUP-890-300",
          "type": "CDM"
        },
        {
          "code": "L8606",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1223.73,
          "discounted_cash": 795.42,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 784.41
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1040.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 679.17
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1223.73
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1073.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 784.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 934.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 673.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 784.41
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 990
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1040.17
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1040.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1040.17
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1040.17
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 917.8
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1076.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 746.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 796.65
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 673.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1003.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 796.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 801.54
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1040.17
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 807.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1003.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 796.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1003.46
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 784.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 679.17
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1014.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 746.48
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 801.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 934.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 784.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 801.54
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 746.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 746.48
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 746.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 781.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 934.93
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1040.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1040.17
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 893.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1003.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1003.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 801.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 801.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 917.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 673.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 679.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 679.17
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 746.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 746.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 781.96
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1040.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1040.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 934.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 784.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 673.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 746.48
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1040.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 673.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 784.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 934.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 893.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 746.48
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 801.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1003.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 796.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 784.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 746.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 796.65
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1040.17
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1040.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 893.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 893.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 784.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 781.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 784.41
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 334.08
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 268
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1223.73,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 893.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1003.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1003.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 746.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 746.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 784.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1073.21
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1040.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 673.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 784.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 934.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 990
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 801.54
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 795.42
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 917.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 801.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1014.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 781.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 746.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 673.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 893.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1014.47
            }
          ]
        }
      ]
    },
    {
      "description": "IMPLANT 5 X 5CM MESHED BI-LAYER MATRIX WOUND DRESSING PER SQ CM",
      "code_information": [
        {
          "code": "SUP-MWM2021",
          "type": "CDM"
        },
        {
          "code": "Q4104",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 276.75,
          "discounted_cash": 179.89,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 211.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 229.43
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 75.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 153.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 229.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 153.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.67
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 174.91
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 276.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 180.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 174.91
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 174.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 182.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.67
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.24
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 207.56
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 211.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 202.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 207.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 207.56
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 229.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 202.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.94
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.21
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 202.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.67
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.24
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 243.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 223.89
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 153.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 174.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 174.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 202.03
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 180.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 153.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 180.16
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 211.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 202.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 180.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 174.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 242.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 242.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.94
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 211.44
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 179.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 180.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 202.03
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 174.91
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 211.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.94
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.24
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 223.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 211.44
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 174.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 276.75,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "INSERT 13MM SZ1-2 CONSTRAINED GEN II",
      "code_information": [
        {
          "code": "SUP-71420962",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8580,
          "discounted_cash": 5577,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5499.78
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5577
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5585.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5619.9
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5233.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5233.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5585.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6555.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4761.9
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5482.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5499.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5499.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4719
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4719
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5499.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7112.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5233.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5499.78
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7293
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6263.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5585.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4719
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4719
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7550.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6555.12
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7293
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5499.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6555.12
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5619.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5233.8
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4719
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7293
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7035.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5233.8
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7293
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7035.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5233.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1544.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6555.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7293
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6435
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5619.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6263.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5499.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7035.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5482.62
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6263.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5619.9
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7293
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7293
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5619.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7524.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6263.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6941.22
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4761.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7035.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4719
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7035.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5233.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6941.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5499.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5233.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5499.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6435
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1879.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5585.58
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2342.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5233.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5499.78
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7293
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6263.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7112.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7035.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7524.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5233.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7293
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7293
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4761.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5619.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5499.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6263.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5233.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5585.58
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1544.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7293
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7035.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4719
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6435
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7112.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5233.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5662.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5233.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5482.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8580
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5619.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5499.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7293
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4761.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5482.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5619.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7293
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6555.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7035.6
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8580,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7293
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6555.12
            }
          ]
        }
      ]
    },
    {
      "description": "INSERT SZ1 6MM RT AND LT THICK POLY INBONE II EVERLAST",
      "code_information": [
        {
          "code": "SUP-22022106",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4599,
          "discounted_cash": 2989.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3513.64
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3909.15
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1255.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2805.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3513.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3513.64
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3513.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2947.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2552.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3812.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3012.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2552.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2805.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2938.76
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3909.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2947.96
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3357.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3771.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2805.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2805.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2805.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3012.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3012.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2947.96
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3909.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3771.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2938.76
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3012.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2529.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4599
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2947.96
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3909.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3771.18
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2989.35
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3449.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2805.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2529.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2993.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2947.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3357.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3357.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2805.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2993.95
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2552.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3909.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2529.45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3012.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3357.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2805.39
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3909.15
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3909.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2805.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2993.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2993.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2947.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2947.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2529.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3771.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2993.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3012.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3812.57
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3771.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2529.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3720.59
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2947.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3513.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3449.25
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3035.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3012.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3357.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3812.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4033.32
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3909.15
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3909.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2552.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2805.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3771.18
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4047.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2529.45
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1007.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2805.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2938.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2805.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2938.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3720.59
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3449.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2947.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3909.15
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3909.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2805.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2947.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3909.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3909.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2529.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3357.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3771.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3513.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3909.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3012.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2947.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2947.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4033.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3771.18
            }
          ]
        }
      ]
    },
    {
      "description": "BIT 2.3MM DRILL ULNAR SHORTENING LOW PROFILE RAYHACK",
      "code_information": [
        {
          "code": "SUP-40100523",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 249,
          "discounted_cash": 161.85,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 190.24
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 211.65
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 219.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 206.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 156.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 136.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 136.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 162.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 190.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 157.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 204.18
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 249,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 204.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 156.37
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 164.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 138.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 157.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 211.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 138.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 157.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 159.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 161.6
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 211.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 138.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 249
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 156.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 162.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 218.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 157.37
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 211.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 211.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 211.65
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 186.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 190.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 159.86
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 211.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 206.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 161.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 181.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 181.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 204.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 136.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 190.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 159.86
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 211.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 159.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 159.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 206.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 156.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 162.1
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 67.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 159.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 138.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 156.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 204.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 156.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 211.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 218.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 159.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 156.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 201.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 190.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 190.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 204.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 157.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 159.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 181.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 161.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 211.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 181.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 157.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 156.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 156.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 156.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 162.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 201.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 162.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 136.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 186.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 136.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 181.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 159.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 204.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 211.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 157.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 204.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 204.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 156.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 161.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 136.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 159.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 186.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 181.77
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 211.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 156.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 157.37
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 161.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 159.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 159.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 156.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 136.95
            }
          ]
        }
      ]
    },
    {
      "description": "GRAFT 5CC BONE SUB REGENERATIVE INJECTABLE PRO-DENSE",
      "code_information": [
        {
          "code": "SUP-87SR-0050",
          "type": "CDM"
        },
        {
          "code": "C1734",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4464,
          "discounted_cash": 2901.6,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2861.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3794.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2455.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3258.72
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3794.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2861.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3700.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3660.48
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2861.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2852.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2906.06
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3794.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2861.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2723.04
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4464,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2477.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2723.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2477.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3660.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2723.04
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2923.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3914.93
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3794.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2455.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3794.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4464
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2723.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2852.5
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 3928.32
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3794.4
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2923.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2923.92
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3794.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3794.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2723.04
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4464,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3410.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2861.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2861.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3410.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3258.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2861.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3410.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3794.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2852.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2455.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3410.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1218.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3410.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3348
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2861.42
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1704.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3258.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2477.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3700.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2723.04
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4464,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2923.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2861.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2455.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3258.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3700.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2723.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2723.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2477.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2723.04
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3611.38
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2901.6
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2455.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2455.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3660.48
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2861.42
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3794.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2923.92
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3794.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3660.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2723.04
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3794.4
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2906.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2923.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2923.92
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3348
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3258.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2723.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2906.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3794.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3660.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3660.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2852.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3660.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2923.92
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4464,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4464,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2946.24
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 977.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2455.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3258.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3660.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2723.04
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2861.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2906.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2906.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3611.38
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3794.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3410.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3914.93
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3348
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1623.02,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2723.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2861.42
            }
          ]
        }
      ]
    },
    {
      "description": "SET IMPLANT PLANTAR PLATE GRAVITY",
      "code_information": [
        {
          "code": "SUP-86PPS1N0",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2916,
          "discounted_cash": 1895.4,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1869.16
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2478.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2478.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2391.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1778.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1778.76
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1869.16
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1603.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2478.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1603.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2557.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1603.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1603.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1869.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2227.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2128.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2128.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1618.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1863.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1898.32
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1909.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2417.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1869.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1869.16
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2187
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2478.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2187
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2391.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1909.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1618.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1778.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1603.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2128.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2478.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2227.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2916
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1778.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1909.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1909.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2128.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2391.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1778.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2227.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2187
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1618.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1898.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1898.32
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1898.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1869.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2417.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1898.32
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1869.16
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2391.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1778.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1863.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2391.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1869.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2478.6
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2557.33
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 638.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2478.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1603.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1618.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2391.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1778.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2359.04
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1778.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1863.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2359.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1869.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1909.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1869.16
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2478.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2128.68
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1924.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1909.98
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2478.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2227.82
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2128.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2391.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1778.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1603.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1869.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2478.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2478.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2478.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1778.76
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2227.82
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 796.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1909.98
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2566.08
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1895.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1909.98
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2478.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2417.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1863.32
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1778.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1778.76
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2478.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2227.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2391.12
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2916,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1869.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1778.76
            }
          ]
        }
      ]
    },
    {
      "description": "PLATE T 3 X 5HL 47MM NAR LOCK VARIAX 2.7",
      "code_information": [
        {
          "code": "SUP-629784",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5091,
          "discounted_cash": 3309.15,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3263.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3105.51
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3309.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3105.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2825.51
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 916.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4327.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2825.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3105.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3105.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4327.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5091
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4220.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4174.62
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4327.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3253.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3105.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2800.05
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3818.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4327.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2800.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2800.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3334.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4464.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3334.61
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4327.35
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 916.38
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3263.33
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4118.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4220.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4220.44
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3263.33
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3263.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3889.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4327.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4174.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3314.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4464.81
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1389.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3334.61
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4327.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3105.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3334.61
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4174.62
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1114.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3889.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3263.33
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4327.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3105.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3889.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3716.43
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4327.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3263.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3263.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4174.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4174.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3314.24
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4327.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3263.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3334.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3716.43
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4480.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2800.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4174.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3105.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4174.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3253.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3263.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3889.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3263.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4174.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3253.15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3105.51
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3818.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3716.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3314.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2800.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3105.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2825.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3334.61
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3889.52
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2800.05
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4327.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3334.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3263.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3263.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3716.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3889.52
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3360.06
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4327.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2800.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4118.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3314.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3314.24
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4327.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3818.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3716.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3105.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3105.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3716.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2825.51
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3253.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3334.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3105.51
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5091,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4327.35
            }
          ]
        }
      ]
    },
    {
      "description": "PLATE 8HL 115MM BROAD LOCK COMPRESSION TI AXSOS",
      "code_information": [
        {
          "code": "SUP-627568",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8235,
          "discounted_cash": 5352.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5278.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6752.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5262.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5360.99
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6999.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6752.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5023.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5023.35
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5278.64
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5023.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6999.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6291.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5393.93
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5352.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5393.93
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7222.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5278.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6011.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6752.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5262.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5360.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5360.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6662.12
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6999.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1482.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5278.64
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6999.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5360.99
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6176.25
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6999.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6011.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6011.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6826.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5023.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5393.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6999.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4529.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4570.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5023.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5278.64
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6011.55
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2248.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5393.93
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6999.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4570.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6826.82
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5023.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5393.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6291.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6752.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5023.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5023.35
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1482.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6999.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5262.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6662.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6291.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6291.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5278.64
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5023.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5023.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4529.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5393.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5262.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6826.82
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6999.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6999.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6999.75
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5278.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5278.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5278.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5278.64
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6752.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5278.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6999.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4529.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4570.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6011.55
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4529.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6752.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7222.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6752.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6999.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6176.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8235
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6176.25
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5435.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6291.54
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6999.75
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4529.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5023.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5393.93
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6011.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4529.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4570.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5023.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6752.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5023.35
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7246.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5278.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4529.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8235,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1803.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6291.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5393.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5360.99
            }
          ]
        }
      ]
    },
    {
      "description": "BIT 1.6 X 96MM DRILL AO SCALED VARIAX",
      "code_information": [
        {
          "code": "SUP-705133",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 582,
          "discounted_cash": 378.3,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 373.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 373.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 494.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 424.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 367.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 377.72
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 494.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 365.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 365.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 365.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 444.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 373.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 373.64
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 494.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 477.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 365.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 365.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 378.88
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 378.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 373.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 482.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 323.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 582
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 320.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 320.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 436.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 494.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 365.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 444.65
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 494.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 323.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 367.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 444.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 477.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 482.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 365.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 424.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 373.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 373.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 377.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 367.82
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 494.7
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 158.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 373.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 494.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 477.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 510.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 444.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 320.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 320.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 373.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 444.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 444.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 494.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 477.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 378.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 320.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 323.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 365.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 373.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 367.82
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 512.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 367.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 365.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 424.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 477.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 477.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 378.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 436.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 424.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 367.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 424.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 365.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 494.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 436.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 323.01
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 384.12
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 582,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 377.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 367.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 320.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 373.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 367.82
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 494.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 365.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 378.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 482.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 477.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 477.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 365.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 377.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 494.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 494.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 373.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 424.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 470.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 510.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 365.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 378.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 320.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 470.84
            }
          ]
        }
      ]
    },
    {
      "description": "BIT 2 X 105MM DRILL ADD-ON FITTED SCALED VARIAX 2",
      "code_information": [
        {
          "code": "SUP-705134",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1005,
          "discounted_cash": 653.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.21
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 274.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 733.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 824.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 652.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 767.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 557.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 733.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 635.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 652.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 631.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 631.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 652.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 552.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 635.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 833.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 635.16
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 854.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 733.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 552.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 557.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 631.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.21
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 663.3
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 854.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 733.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 631.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 631.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 824.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 635.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 552.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 552.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 552.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 767.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 753.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 767.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 557.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 635.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 753.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 654.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 881.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 733.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 733.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 824.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 631.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 833.15
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1005,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 854.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 635.16
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 854.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 654.26
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 884.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 854.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 557.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 824.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 635.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 813.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 854.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 767.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 824.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 631.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 631.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 854.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 824.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 635.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 552.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 631.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 854.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 753.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 631.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 654.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 652.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 631.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 854.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 854.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 767.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 552.75
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 653.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.21
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 854.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 645.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 833.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 631.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 813.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 881.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 767.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 631.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 654.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1005
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 824.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 654.26
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 854.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 824.1
            }
          ]
        }
      ]
    },
    {
      "description": "BIT 3.2 X 216MM DRILL SHORT NONLOCK AXSOS",
      "code_information": [
        {
          "code": "SUP-705032",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 793.8,
          "discounted_cash": 515.97,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 696.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.59
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 515.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 440.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 650.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 498.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.73
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 595.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 650.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 498.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 498.51
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 515.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 606.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 515.18
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 793.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 658.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 498.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 516.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 606.46
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 515.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 793.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 516.76
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 579.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 579.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 579.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 650.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 498.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 658.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 515.18
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 523.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 696.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 658.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 650.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 498.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 516.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 606.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 595.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 595.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 498.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 642.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 650.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 650.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 650.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.68
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 216.71
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 440.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 498.51
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 698.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 516.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 498.51
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 606.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 579.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 498.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 498.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 498.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 440.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 642.18
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 606.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 440.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 516.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 606.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 650.92
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 579.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 579.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 498.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.59
            }
          ]
        }
      ]
    },
    {
      "description": "BIT 2 X 30MM DRILL WRIST FUSION VARIAX 2",
      "code_information": [
        {
          "code": "SUP-703891",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 644.4,
          "discounted_cash": 418.86,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 413.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 418.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 407.26
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 567.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 534.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 354.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 354.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 528.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 413.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 404.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 413.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 470.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 413.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 418.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 407.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 492.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 413.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 407.26
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 644.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 528.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 418.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 418.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 470.41
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 547.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 404.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 413.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 404.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 565.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 528.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 419.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 521.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 404.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 483.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 419.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 565.14
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 547.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 470.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 528.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 419.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 357.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 357.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 404.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 404.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 413.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 413.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 547.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 419.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 547.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 354.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 492.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 418.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 547.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 354.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 407.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 407.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 528.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 407.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 413.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 644.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 357.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 404.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 407.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 528.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 521.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 357.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 354.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 547.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 470.41
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 175.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 483.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 528.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 404.68
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 547.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 470.41
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 483.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 404.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 534.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 404.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 407.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 413.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 413.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 547.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 413.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 470.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 354.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 404.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 404.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 354.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 492.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 492.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 547.74
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 547.74
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 547.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 492.32
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 425.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 528.41
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 547.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 492.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 534.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 419.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 404.68
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 4.5 X 110MM ST CORT T20 DRIVE TI AXSOS 5",
      "code_information": [
        {
          "code": "SUP-661810S",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 237,
          "discounted_cash": 154.05,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 181.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 151.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 151.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 173.01
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 208.56
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 237,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 130.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 181.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 173.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 151.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 151.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 155.24
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 201.45
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 144.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 154.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 154.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 194.34
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 207.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 196.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 151.44
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 173.01
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 155.24
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 201.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 151.92
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 144.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 155.24
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 237,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 130.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 130.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 181.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 201.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 194.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 177.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 201.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 237
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 151.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 151.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 131.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 194.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 194.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 194.34
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 237,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 131.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 144.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 201.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 155.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 181.07
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 201.45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 237,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 151.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 173.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 154.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 155.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 151.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 151.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 191.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 154.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 130.35
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 64.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 151.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 181.07
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 151.92
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 201.45
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 237,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 196.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 194.34
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 154.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 181.07
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 201.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 194.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 173.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 201.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 177.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 144.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 144.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 155.24
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 156.42
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 201.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 131.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 191.73
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 155.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 155.24
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 237,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 173.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 130.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 144.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 201.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 130.35
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 177.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 151.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 151.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 201.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 144.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 207.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 130.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 144.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 154.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 144.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 144.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 144.57
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 201.45
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 144.57
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 194.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 201.45
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 237,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 131.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 196.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 144.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 151.44
            }
          ]
        }
      ]
    },
    {
      "description": "BIT 4.2MM DRILL EX LONG CALIBRATED",
      "code_information": [
        {
          "code": "SUP-03.045.022",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 840,
          "discounted_cash": 546,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 539.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 527.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 527.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 714
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 630
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 688.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 527.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 546.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 539.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 539.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 714
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 546
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 539.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 696.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 630
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 530.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 530.88
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 714
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 714
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 462
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 527.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 539.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 545.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 527.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 641.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 630
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 714
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 688.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 641.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 466.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 527.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 527.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 714
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 679.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 613.2
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 714
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 545.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 641.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 613.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 688.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 530.88
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 229.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 736.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 539.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 714
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 613.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 545.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 527.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 466.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 546.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 679.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 613.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 613.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 530.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 530.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 462
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 688.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 688.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 546.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 539.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 539.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 539.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 840
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 539.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 539.28
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 714
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 539.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 466.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 530.88
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 840,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 527.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 530.88
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 714
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 688.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 527.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 546.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 696.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 527.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 641.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 613.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 462
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 696.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 736.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 462
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 527.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 527.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 641.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 462
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 546.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 688.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 530.88
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 714
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 714
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 545.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 641.76
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 554.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 466.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 688.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 462
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 462
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 739.2
            }
          ]
        }
      ]
    },
    {
      "description": "NAIL 10 X 240MM PERIPROSTHETIC BEND BEND RFN-ADVANCED",
      "code_information": [
        {
          "code": "SUP-04.233.025S",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6987.12,
          "discounted_cash": 4541.63,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5338.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5240.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4262.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4262.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4464.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3877.85
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3842.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5100.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3842.92
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4262.14
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5939.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5939.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5729.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3842.92
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5939.05
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5939.05
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5100.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5729.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3877.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5939.05
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5939.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3877.85
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4541.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4262.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5338.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5338.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5338.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5338.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5100.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4576.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5792.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5729.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6127.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5939.05
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4478.74
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4548.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4548.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4576.56
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4262.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4478.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5792.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5729.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5729.44
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5240.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5939.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4576.56
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5939.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5729.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4262.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5652.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4478.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4478.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4464.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4576.56
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5939.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3842.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4576.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5338.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3842.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6127.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5729.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4262.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4262.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4576.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4478.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4478.74
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5240.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5100.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4262.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3842.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4478.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4548.62
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4576.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5100.6
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1907.48
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5939.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6987.12
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4548.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5939.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4548.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3877.85
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4478.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4478.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4262.14
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5939.05
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4611.5
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1530.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4262.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4262.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4464.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4464.77
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5652.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5792.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4576.56
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6148.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3842.92
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5939.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4478.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4478.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5729.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4262.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4478.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5100.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6987.12,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 5 X 48MM LOCK STERL T25 STARDRV RECESS FNS",
      "code_information": [
        {
          "code": "SUP-412.218S",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 560.04,
          "discounted_cash": 364.03,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 427.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 358.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 357.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 341.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 308.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 308.02
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 476.03
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 408.83
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 491.16
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 308.02
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 476.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 358.99
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 476.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 560.04
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 310.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 459.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 341.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 364.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 364.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 459.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 341.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 408.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 366.83
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 476.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 408.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 408.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 358.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 420.03
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 364.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 476.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 408.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 364.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 476.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 308.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 308.02
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 476.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 459.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 341.62
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 369.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 308.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 459.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 453.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 453.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 366.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 408.83
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 358.99
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 341.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 358.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 427.87
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 476.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 464.27
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 358.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 341.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 357.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 476.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 366.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 427.87
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 420.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 341.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 341.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 491.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 341.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 310.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 464.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 459.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 358.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 310.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 459.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 341.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 357.87
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 366.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 366.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 427.87
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 310.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 366.83
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 476.03
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 152.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 476.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 308.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 459.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 364.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 358.99
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 366.83
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 492.84
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 476.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 464.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 358.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 427.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 357.87
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 476.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 358.99
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 341.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 459.23
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 476.03
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 420.03
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 341.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 358.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 427.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 364.59
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 366.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 358.99
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 341.62
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 560.04,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 5 X 10MM VA PP LOCK SELFTAP SS T25 STARDRV OPTILINK",
      "code_information": [
        {
          "code": "SUP-42.231.010",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 769.56,
          "discounted_cash": 500.21,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 493.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 561.78
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 210.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 637.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 504.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 500.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 622.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 587.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 587.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 427.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 469.43
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 507.91
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 654.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 423.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 423.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 493.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 631.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 469.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 654.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 587.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 493.29
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 769.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 469.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 631.04
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 587.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 491.75
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 654.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 631.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 427.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 423.26
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 654.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 491.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 654.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 469.43
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 500.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 654.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 561.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 423.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 469.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 469.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 500.98
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 674.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 493.29
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 423.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 469.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 493.29
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 423.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 654.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 631.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 469.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 469.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 500.98
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 654.13
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 500.98
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 654.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 561.78
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 577.17
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 504.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 504.06
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 654.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 427.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 561.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 427.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 637.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 631.04
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 654.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 674.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 654.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 631.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 469.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 493.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 631.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 504.06
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 654.13
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 469.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 622.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 504.06
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 654.13
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 493.29
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 423.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 504.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 493.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 587.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 493.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 637.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 469.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 500.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 561.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 493.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 493.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 587.94
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 677.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 469.43
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 493.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 577.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 561.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 491.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 491.75
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 504.06
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 769.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 577.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 504.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 631.04
            }
          ]
        }
      ]
    },
    {
      "description": "BIT 4.2 X 145MM DRILL CALIBRATED 3 FLUTE QC",
      "code_information": [
        {
          "code": "SUP-SD03.010.104",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1296,
          "discounted_cash": 842.4,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 990.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1062.72
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 972
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 842.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 712.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1296,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 712.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1062.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1062.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 990.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1062.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 841.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1101.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 946.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 712.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1101.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 990.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 990.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1048.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 972
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 855.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 832.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 719.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 841.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 843.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1074.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 832.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1101.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1101.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1101.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 843.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 712.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 819.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 832.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 832.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1062.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 819.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 843.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 843.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 841.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 819.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1136.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 719.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1062.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 843.7
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1101.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 946.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 819.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 712.8
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1140.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 946.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 719.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 841.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1074.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 832.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1101.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 712.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 819.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 990.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 946.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 819.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1062.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1048.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1136.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 832.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 719.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 832.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 819.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.89
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 353.81
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1101.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1101.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1101.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 832.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 990.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 712.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1062.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 819.07
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1101.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 946.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 832.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 832.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 832.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 972
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1074.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 813.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 832.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 946.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1296
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1101.6
            }
          ]
        }
      ]
    },
    {
      "description": "GUIDE CUTTING TIBIA W/ BONE MODEL PERSONA PARTIAL KNEE PSI",
      "code_information": [
        {
          "code": "SUP-110045560",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4140,
          "discounted_cash": 2691,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 2657.88
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1130.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2616.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2686.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3432.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2686.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3022.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2657.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3022.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3519
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2277
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3519
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3162.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2297.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3519
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2691
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2616.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2599.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2599.92
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3519
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3162.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2657.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2657.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3022.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3394.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2599.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3349.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3394.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3394.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3630.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2616.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3105
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3519
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3519
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2695.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3162.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3349.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2695.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3022.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2599.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3630.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2657.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3162.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2657.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2297.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2695.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2277
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2616.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3394.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2657.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3105
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3162.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3432.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2599.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3519
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3022.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2277
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2277
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3394.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2599.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3394.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2277
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2657.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2277
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 3643.2
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2732.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3432.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2599.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2599.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2657.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2599.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2695.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2695.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2277
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2616.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2657.88
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3519
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3022.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3394.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2599.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2599.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2686.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2297.7
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3519
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2657.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2616.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2616.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3162.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2686.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2657.88
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3519
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3519
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4140,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4140
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2297.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2599.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2599.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3519
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3105
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2616.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3394.8
            }
          ]
        }
      ]
    },
    {
      "description": "KIT REPAIR SYNDESMOSIS KNOTLESS W/CONSTRICTOR SYNDEX",
      "code_information": [
        {
          "code": "SUP-MSYN0000",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3300,
          "discounted_cash": 2145,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2115.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2115.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2805
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2805
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2669.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2805
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1815
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 900.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2805
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2013
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2735.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2115.3
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1815
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2805
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2904
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2115.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2521.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2115.3
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2161.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2706
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2108.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2805
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2409
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2805
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1831.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2013
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2161.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2706
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2669.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1831.5
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2805
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1815
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2013
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2013
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2409
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2148.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2161.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2161.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2521.2
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2013
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2148.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2148.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2706
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2115.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2894.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2108.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2521.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2521.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2013
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2161.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1815
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2409
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2706
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2013
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1831.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2475
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2521.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1815
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2706
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2115.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2805
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2013
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2013
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3300
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2706
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2013
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2108.7
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2805
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2115.3
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2409
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2894.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2115.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2145
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2409
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2161.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2735.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1815
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2013
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2805
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2148.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2115.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1831.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2115.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2475
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2475
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2805
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2013
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2706
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2178
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2409
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2805
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3300,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2148.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2013
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2161.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2521.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2115.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2706
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2161.5
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 722.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2735.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2805
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1815
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2108.7
            }
          ]
        }
      ]
    },
    {
      "description": "COMPONENT SZD 0DEG RT TIB CEMENTLESS KEEL OSSEOTI PERSONA",
      "code_information": [
        {
          "code": "SUP-42-5350-067-02",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4845,
          "discounted_cash": 3149.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3701.58
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3197.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3536.85
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4118.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2688.98
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4263.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4118.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2664.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3095.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3105.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3972.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2955.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3154.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3536.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3173.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2955.45
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3173.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3105.65
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4118.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4118.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4845
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2688.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2955.45
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1061.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4016.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3972.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3095.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4118.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3154.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3105.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3633.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2955.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2664.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3154.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3919.61
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3105.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3173.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3633.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4249.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4249.07
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3095.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2955.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2688.98
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 872.1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 872.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3149.25
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2664.75
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1322.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3173.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3105.65
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4118.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3105.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3105.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4118.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4016.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3173.48
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4118.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2688.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3972.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2955.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2955.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3173.48
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4118.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3972.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3972.9
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3154.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2664.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3972.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3105.65
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4118.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2955.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3154.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3105.65
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3173.48
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4118.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3105.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3105.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4118.25
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3972.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2955.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2955.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3095.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2664.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2664.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3701.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3536.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2664.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3633.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3173.48
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4118.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3536.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3536.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2955.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2955.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3919.61
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3105.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3701.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3701.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3701.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3701.58
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4118.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4845,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4016.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3972.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2955.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3536.85
            }
          ]
        }
      ]
    },
    {
      "description": "BIT 2 X 14MM DRILL RIBULOC U PLUS 90",
      "code_information": [
        {
          "code": "SUP-RBL2315",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 741,
          "discounted_cash": 481.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 475.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 465.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 465.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 465.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 468.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 407.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 607.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 465.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 482.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 475.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 407.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 480.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 475.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 468.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 614.29
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 741,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 629.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 607.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 465.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 566.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 629.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 555.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 465.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 465.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 480.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 475.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 465.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 411.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 480.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 599.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 566.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 566.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 475.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 741
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 614.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 555.75
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 652.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 475.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 475.72
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 202.29
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 629.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 407.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 599.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 649.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 607.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 607.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 411.26
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 629.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 475.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 540.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 540.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 607.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 566.12
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 629.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 607.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 465.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 629.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 607.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 475.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 566.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 540.93
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 555.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 480.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 482.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 482.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 482.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 629.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 540.93
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 629.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 468.31
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 489.06
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 629.85
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 481.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 649.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 475.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 465.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 465.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 468.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 475.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 411.26
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 629.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 407.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 607.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 465.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 465.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 468.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 468.31
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 629.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 614.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 468.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 629.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 407.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 407.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 407.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 540.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 475.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 566.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 411.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 540.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 468.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 482.39
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 6.5 X 20MM CANN LOCK CANC THRD TI",
      "code_information": [
        {
          "code": "SUP-CP-161941",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1140,
          "discounted_cash": 741,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 870.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 730.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 855
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 627
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 695.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 742.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 969
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 969
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 730.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 632.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 632.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 632.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 695.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 832.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 746.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 969
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 730.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 870.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 855
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 969
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 742.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 999.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 695.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 922.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 742.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 730.74
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 746.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 730.74
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 934.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 695.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 627
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 969
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 934.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 746.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 730.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 832.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 969
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 870.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 969
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 969
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 632.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 695.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 695.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 695.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 746.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 870.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 934.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 934.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 922.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 945.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 695.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 746.7
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 934.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 695.4
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 969
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 627
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 969
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 746.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 627
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 855
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 728.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 728.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 934.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 695.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 969
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 728.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 999.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 832.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 969
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 934.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 945.06
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 945.06
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 627
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 730.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 730.74
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 752.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 695.4
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 627
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1140
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 695.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 741
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 969
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 832.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 832.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 730.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 870.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 730.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 969
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 832.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 746.7
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 249.66
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1003.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 695.4
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 746.7
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 934.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 742.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 730.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 730.74
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1140,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 627
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 870.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 728.46
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 311.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 742.14
            }
          ]
        }
      ]
    },
    {
      "description": "KIT FOOTPLATE SUPPORT MAXFRAME",
      "code_information": [
        {
          "code": "SUP-03.312.010",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2304.72,
          "discounted_cash": 1498.07,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1479.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1447.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1447.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1267.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1479.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1682.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1682.45
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1479.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1910.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1889.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1447.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1495.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1728.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2021.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1864.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1267.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1267.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1910.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1447.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1447.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1682.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1682.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2304.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1889.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1495.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1279.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1456.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1456.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1910.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1889.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1495.76
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1267.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1479.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1479.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1760.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1456.58
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1495.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1456.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1760.81
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1498.07
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2028.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1889.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1447.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1500.37
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1682.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1500.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1456.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1479.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1479.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1447.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1500.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1447.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1447.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1447.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1456.58
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1728.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1447.36
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 629.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1760.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1760.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1267.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1889.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1456.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1864.52
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1279.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1279.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1267.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1479.63
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2304.72,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1479.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1447.36
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1521.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1682.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2021.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1267.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1500.37
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1760.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1728.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1279.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1500.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1456.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1479.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1889.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1889.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1889.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1760.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1447.36
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1959.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1479.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1479.63
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 2 X 24MM COMP HEADLESS CANN SHORT THRD TI CCHS SYS",
      "code_information": [
        {
          "code": "SUP-04.333.024",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1160.7,
          "discounted_cash": 754.45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 744.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 744.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 870.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1017.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 939.01
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 847.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 708.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 755.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 744.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 847.31
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 986.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 986.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 870.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 760.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 760.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 644.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 744.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 847.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 760.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 708.03
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 951.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 708.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 755.62
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 754.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1160.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 986.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 886.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 847.31
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 708.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 708.03
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 638.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 644.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 741.69
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 744.01
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 986.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 886.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 886.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 951.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 708.03
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 986.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 847.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 847.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 886.77
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 254.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 870.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 708.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 886.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 951.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 951.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 986.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 986.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 638.39
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 708.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 744.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 962.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 760.26
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 986.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 951.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 755.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 755.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 986.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 644.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 644.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 741.69
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 744.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 744.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 638.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 951.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 939.01
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 316.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 760.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 760.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 741.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 638.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 638.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 951.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 708.03
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 760.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 744.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 744.01
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 744.01
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1017.93
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 986.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 951.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 760.26
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 638.39
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 708.03
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 741.69
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 766.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 962.22
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 986.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 638.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 755.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 708.03
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1021.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 744.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 986.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 708.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 886.77
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 986.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 962.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 708.03
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 986.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1160.7,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "SEALANT 10ML HEMOSTATIC MATRIX FAST PREP FLOSEAL W/RECOTHROM",
      "code_information": [
        {
          "code": "SUP-ADS202110",
          "type": "CDM"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 744.74,
          "discounted_cash": 484.08,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 478.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 478.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 413.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 610.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 602.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 409.61
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 633.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 633.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 483.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 484.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 478.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 484.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 543.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 617.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 617.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 478.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 610.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 483.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 467.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 467.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 610.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 484.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 470.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 470.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 568.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 568.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 409.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 467.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 633.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 653.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 543.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 409.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 413.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 467.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 483.34
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 203.31
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 633.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 409.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 467.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 467.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 568.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 610.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 484.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 413.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 470.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 543.66
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 484.08
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 655.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 610.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 602.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 478.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 568.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 478.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 543.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 470.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 470.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 633.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 409.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 467.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 484.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 409.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 470.68
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 633.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 568.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 543.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 610.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 478.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 633.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 470.68
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 491.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 744.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 653.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 467.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 478.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 478.12
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 633.03
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 744.74,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 558.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 633.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 568.98
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 633.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 478.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 558.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 478.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 478.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 558.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 409.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 467.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 617.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 467.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 467.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 483.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 470.68
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 633.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 633.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 543.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 610.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 610.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 467.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 413.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 467.7
            }
          ]
        }
      ]
    },
    {
      "description": "HEMOSTAT 4 X 8IN SURGICEL ORIGINAL ABSORBABLE",
      "code_information": [
        {
          "code": "SUP-JJ1952S",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 287.42,
          "discounted_cash": 186.82,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184.52
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 244.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 159.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 238.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 186.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 244.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 159.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 244.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 158.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 181.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 219.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 244.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 180.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 180.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 219.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 180.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 244.31
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 287.42,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 287.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 180.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 180.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 186.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 244.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 235.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 158.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 235.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 187.11
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 186.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 181.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 235.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 235.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 215.57
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 189.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 209.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 180.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 209.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 180.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 187.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 232.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 238.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 180.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 219.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 238.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 187.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 187.11
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 244.31
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 244.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 159.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 180.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 209.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 180.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 252.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 181.65
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 252.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 158.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 186.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 186.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 235.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 219.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 215.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 219.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 209.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 209.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 181.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 158.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 158.08
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 215.57
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 244.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 181.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 158.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 219.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 235.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 235.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184.52
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 78.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 181.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 180.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 232.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 181.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 209.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 184.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 180.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 181.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 244.31
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 244.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 235.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 180.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 187.11
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 244.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 252.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 158.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 159.52
            }
          ]
        }
      ]
    },
    {
      "description": "INTRODUCER CATH SUPRAPUBIC",
      "code_information": [
        {
          "code": "SUP-SFS16851",
          "type": "CDM"
        },
        {
          "code": "C1894",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 57,
          "discounted_cash": 37.05,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.59
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 50.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.02
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 31.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 37.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 37.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.02
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 42.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.45
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.45
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 42.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.55
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.02
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 47.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.45
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 42.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 49.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 47.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.74
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.59
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.45
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 46.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.59
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.45
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 49.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 46.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 31.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.45
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 31.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 47.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.74
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 15.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 31.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.45
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 57,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 57,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 57,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "KIT 5CC FAST CURE MINI BEAD RESORB OSTEOSET",
      "code_information": [
        {
          "code": "SUP-84000611",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1650,
          "discounted_cash": 1072.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1057.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1237.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 915.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 907.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1650
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1260.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1204.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1353
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1260.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1402.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1080.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1402.5
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1089
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1080.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1260.6
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1402.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1057.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1402.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1353
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1006.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1006.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 450.45
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1402.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1447.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1057.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1057.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1402.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1367.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1353
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1260.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 915.75
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1204.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1402.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1260.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1054.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1204.5
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1074.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1367.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1006.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1006.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1080.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1080.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1080.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1057.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1402.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1006.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1447.05
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 907.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1237.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 915.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1353
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1054.35
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 361.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1353
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1334.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1057.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1057.65
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1452
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 907.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 907.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 915.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1006.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1006.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1402.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1367.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1402.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1402.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 907.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1006.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1204.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1080.75
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1072.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1057.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1260.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1237.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1353
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1353
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1080.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1006.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1080.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1204.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1054.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1006.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1402.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1006.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1006.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1057.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1057.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1074.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1353
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1074.15
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 907.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1057.65
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1204.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1054.35
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1650,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1402.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1057.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1402.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1006.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1334.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1074.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 907.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1074.15
            }
          ]
        }
      ]
    },
    {
      "description": "SYSTEM CUSTOMIZABLE INCISION MGMT PREVENA PLUS",
      "code_information": [
        {
          "code": "SUP-PRE4001US",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1641,
          "discounted_cash": 1066.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1253.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1053.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1345.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 902.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1641
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1068.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1197.93
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 447.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1030.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1197.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1394.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 902.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1439.16
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1394.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1360.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 910.76
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1394.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1253.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1230.75
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1394.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1394.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1053.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1037.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1030.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1053.52
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1394.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1068.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1439.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 902.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1230.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1394.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1030.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1030.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1030.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1030.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1053.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1037.11
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1394.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1053.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1253.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1030.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1068.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1037.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1053.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1030.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1327.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1053.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1345.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1030.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1327.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 902.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1197.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 902.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1065.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1030.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1360.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1030.55
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1066.65
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1444.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 902.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1030.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1037.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 910.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1065.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1360.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1345.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1345.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1053.52
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1083.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 910.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1030.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1053.52
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1641,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1345.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1065.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1068.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1053.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1197.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1197.93
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1394.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1037.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1068.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1345.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1197.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1037.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1053.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1037.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1345.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1345.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1394.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 902.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1253.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1253.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1065.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1053.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1253.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1394.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 910.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1037.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1394.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1230.75
            }
          ]
        }
      ]
    },
    {
      "description": "LINER 28 X 50 10DEG DUR MAR",
      "code_information": [
        {
          "code": "SUP-122028150",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3580.2,
          "discounted_cash": 2327.13,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2735.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2183.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2183.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2287.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2287.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1969.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2183.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2935.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2294.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3043.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2613.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2330.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2330.71
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2345.03
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2935.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2935.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3043.17
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2613.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2183.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2183.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1987.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2967.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2183.92
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3043.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2294.91
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3043.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2613.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3043.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2935.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2294.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2613.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2735.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2294.91
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2345.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2294.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2294.91
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1987.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3580.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3043.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2294.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1987.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2183.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2183.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3139.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2294.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3043.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3043.17
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1969.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2183.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2735.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2294.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2294.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2935.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2183.92
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2967.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2896.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1969.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2345.03
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3043.17
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2735.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2935.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2345.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2345.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3043.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1969.11
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3043.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2345.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2613.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2685.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2330.71
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1969.11
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2613.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1987.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2896.38
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2685.15
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2362.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2345.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2967.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2330.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2294.91
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3043.17
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 977.39
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2327.13
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2345.03
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2735.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2287.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2287.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2183.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2294.91
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3043.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2330.71
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2685.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2935.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2183.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2183.92
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 3150.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1969.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2735.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3139.84
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3043.17
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 784.06
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2935.76
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3580.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1969.11
            }
          ]
        }
      ]
    },
    {
      "description": "LINER 36MM SZ 24 HI-WALL ARCOMXL RINGLOC",
      "code_information": [
        {
          "code": "SUP-XL-105914",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1853.67,
          "discounted_cash": 1204.89,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1188.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1575.62
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1204.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1520.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1520.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1575.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1536.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1188.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1353.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1019.52
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1575.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1188.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1188.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1130.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1130.74
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1223.42
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1631.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1520.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1130.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1520.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1130.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1188.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1353.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1536.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1130.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1130.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1416.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1019.52
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1188.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1390.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1184.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1019.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1130.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1499.62
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1390.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1575.62
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1575.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1353.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1214.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1575.62
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1575.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1184.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1575.62
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1206.74
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1130.74
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1390.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1214.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1184.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1188.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1416.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1206.74
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1625.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1028.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1520.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1130.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1130.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1499.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1019.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1214.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1625.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1188.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1188.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1188.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1575.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1130.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1214.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1188.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1188.2
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1575.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1028.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1520.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1206.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1214.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1028.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1416.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1575.62
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1416.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1853.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1416.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1353.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1214.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1028.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1130.74
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1206.74
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 506.05
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1184.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1520.01
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1019.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1214.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1353.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1019.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1520.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1130.74
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1019.52
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1575.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1575.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1416.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1536.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1206.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1214.15
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 405.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1575.62
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1853.67,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1353.18
            }
          ]
        }
      ]
    },
    {
      "description": "SYSTEM IMPLANT PERIPHERAL NERVE STIMULATOR REVI MIN ORDER 3",
      "code_information": [
        {
          "code": "SUP-MA-1007-0600-_US_CM",
          "type": "CDM"
        },
        {
          "code": "C1767",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 53550,
          "discounted_cash": 34807.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40912.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 34218.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 43321.95
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 9639
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29452.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43911
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32665.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34861.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 34325.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 34325.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45517.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45517.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 34325.55
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32665.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45517.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29720.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32665.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29452.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45517.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29720.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44392.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 34325.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39091.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 35075.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 35075.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 34325.55
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45517.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45517.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 34807.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 35075.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29720.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 34218.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 34325.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34861.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 53550
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32665.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29452.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 34325.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39091.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29452.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 34325.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40912.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43911
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32665.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 35075.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34861.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39091.5
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45517.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 34325.55
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45517.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 35075.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 34325.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32665.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32665.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45517.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 35075.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45517.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40912.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29452.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43911
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32665.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29452.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40162.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40912.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40912.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 14619.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29452.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29720.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43911
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43911
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 34218.45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 9639
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40162.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45517.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 34325.55
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 43321.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 35075.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45517.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45517.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32665.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 46963.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43911
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34861.05
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 11727.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39091.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 34325.55
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 35343
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45517.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39091.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 46963.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44392.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43911
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34861.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32665.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32665.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40912.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44392.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43911
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32665.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 34218.45
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 53550,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40162.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39091.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 35075.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32665.5
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 47124
            }
          ]
        }
      ]
    },
    {
      "description": "GUIDEWIRE 12G 300CM STR TIP VICTORY 14",
      "code_information": [
        {
          "code": "SUP-39470-30018",
          "type": "CDM"
        },
        {
          "code": "C1769",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 570,
          "discounted_cash": 370.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 499.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 435.48
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 416.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 316.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 371.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 461.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 467.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 472.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 360.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 360.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 472.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 313.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 313.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 371.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 360.24
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 435.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 371.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 360.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 416.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 416.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 499.89
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 313.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 416.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.94
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 376.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 155.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 360.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 435.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 371.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 316.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.94
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 570
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 467.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 371.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 427.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 435.48
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 435.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 313.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 427.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 316.35
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 570,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 316.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 501.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 416.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 416.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 427.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 467.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 467.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 370.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 472.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 461.13
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 570,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 435.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 467.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 467.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 313.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 360.24
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 313.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 365.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 467.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 570,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 360.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 360.24
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 467.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 313.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 484.5
            }
          ]
        }
      ]
    },
    {
      "description": "ADHESIVE 2OZ LIQUID MASTISOL",
      "code_information": [
        {
          "code": "SUP-0496-0523-06",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 70.01,
          "discounted_cash": 45.51,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 19.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.41
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 45.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 58.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 58.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.58
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 46.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 45.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.51
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 70.01,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 38.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.58
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 38.86
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.51
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 58.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 56.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 45.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 45.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.51
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 61.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 45.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 57.41
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 53.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 38.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 61.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 52.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 51.11
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 52.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 56.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 61.4
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 59.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 52.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 44.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 38.86
            }
          ]
        }
      ]
    },
    {
      "description": "SUTURE 0 36IN VICRYL PLUS COATED ETVCP358H CT",
      "code_information": [
        {
          "code": "SUP-VCP358H",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.44,
          "discounted_cash": 2.89,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 3.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.44,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.77
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.33
            }
          ]
        }
      ]
    },
    {
      "description": "SUTURE 0 27IN VICRYL PLUS COATED UNDYED ETVCP694H OS-4",
      "code_information": [
        {
          "code": "SUP-VCP694H",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.88,
          "discounted_cash": 5.77,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.88,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.78
            }
          ]
        }
      ]
    },
    {
      "description": "IMPLANT 190CC BREAST MOD PRO SMOOTH ROUND HSC PLUS SIENTRA",
      "code_information": [
        {
          "code": "SUP-10712-190MP",
          "type": "CDM"
        },
        {
          "code": "C1789",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2640,
          "discounted_cash": 1716,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1692.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2315.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1718.64
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2244
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2244
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1610.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1610.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1686.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1718.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1927.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2016.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2016.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2016.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2164.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1610.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1692.24
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2244
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2244
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1465.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1610.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1729.2
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2244
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2016.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1927.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1610.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2135.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1686.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2135.76
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2244
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1692.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1692.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1692.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1692.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2016.96
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1452
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1465.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1610.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1980
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2640
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1610.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1927.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2164.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1718.64
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1716
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1927.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1729.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1692.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2164.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1729.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1692.24
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2164.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2164.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1610.4
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1452
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1729.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2016.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2244
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1452
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1729.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2244
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1465.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2188.56
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1692.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2244
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1452
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2164.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1610.4
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 720.72
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1692.24
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2188.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1718.64
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 578.16
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1742.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2164.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1610.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1692.24
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1927.2
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1980
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2188.56
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2244
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2244
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2244
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1452
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1610.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1610.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2244
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1718.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1729.2
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2323.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1980
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1610.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1465.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1692.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1452
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2244
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1927.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1729.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2315.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1729.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2164.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1686.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1686.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1452
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2640,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "CATH 4FR URETERAL SPIRAL TIP WOVEN FILIFORM",
      "code_information": [
        {
          "code": "SUP-137904",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 31.56,
          "discounted_cash": 20.51,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 26.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.36
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 26.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 25.53
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 27.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.55
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 8.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.95
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 31.56,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 20.48
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 27.77
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.83
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.83
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 20.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 26.16
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 20.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 23.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 20.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 31.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 20.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 27.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 20.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 25.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.83
            }
          ]
        }
      ]
    },
    {
      "description": "MATRIX 2X 4CM THIN 0.3-0.8 ALLODERM SELECT PER SQ CM",
      "code_information": [
        {
          "code": "SUP-141408",
          "type": "CDM"
        },
        {
          "code": "Q4116",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 239.64,
          "discounted_cash": 155.77,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 153.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 210.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 151.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 198.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 196.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 174.94
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 131.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 183.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 183.08
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 133
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 196.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 151.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 131.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 198.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 196.5
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 203.69
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 151.45
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 183.08
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 210.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 133
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 153.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 153.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 156.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 131.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 153.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 133
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 196.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 183.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 203.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 179.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 174.94
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 198.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 203.69
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 203.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 151.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 153.85
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 174.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 203.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 174.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 174.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 203.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 156.01
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 210.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 153.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 153.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 196.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 193.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 196.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 153.85
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 131.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 203.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 203.69
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 203.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 133
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 203.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 151.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 183.08
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 158.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 203.69
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 131.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 156.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 196.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 155.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 151.45
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 203.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 131.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 153.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 183.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 131.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 153.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 179.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 196.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 193.87
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 65.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 151.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 203.69
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 174.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 153.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 156.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 179.73
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 239.64,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 203.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 156.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 153.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 151.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 239.64
            }
          ]
        }
      ]
    },
    {
      "description": "ULTRASOUND PREMIUM EQUIPMENT F/ LASER SYSTEM",
      "code_information": [
        {
          "code": "SUP-11002-SBDM",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2400,
          "discounted_cash": 1560,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1833.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1507.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1320
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1540.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1833.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1540.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2040
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1320
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1320
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1540.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1968
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1540.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1332
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1507.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1507.2
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2112
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1540.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1752
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1516.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1752
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1540.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1833.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1989.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1507.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1562.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1562.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2040
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2400
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1562.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1989.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2040
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2040
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2104.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2040
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1320
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1968
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1507.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1562.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1562.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1941.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1540.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2040
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1752
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1332
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1968
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1557.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2040
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1516.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1540.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1320
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1507.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1941.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1968
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1833.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1557.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1507.2
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2040
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1540.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1800
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1516.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1968
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 655.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1507.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1540.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1968
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2040
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1516.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2040
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2400,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1800
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1507.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1540.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1752
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1516.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1989.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1833.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1752
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1557.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1507.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1507.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1560
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1320
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1800
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1584
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1516.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1332
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1540.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1968
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2104.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1516.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1332
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1507.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1507.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1320
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1752
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1833.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1557.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1516.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2040
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2040
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1968
            }
          ]
        }
      ]
    },
    {
      "description": "SYSTEM MICRO BYPASS TRABECULAR ISTENT INFINITE",
      "code_information": [
        {
          "code": "SUP-IS3-US",
          "type": "CDM"
        },
        {
          "code": "C1783",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10800,
          "discounted_cash": 7020,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6922.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8100
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8953.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7030.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5940
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9180
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8856
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8251.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8856
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6922.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6922.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5994
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7074
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8251.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8100
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6588
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5940
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6922.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10800
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8953.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8856
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6922.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9180
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9180
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7884
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8856
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6588
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8856
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9180
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7128
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8251.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6922.8
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9180
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9471.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9180
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7884
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6922.8
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 2365.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8856
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6588
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7074
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9471.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1944
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6588
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8856
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7030.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5940
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7074
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7074
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9180
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7074
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7884
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9180
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5994
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5994
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6901.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9180
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6922.8
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7884
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7074
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5994
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6588
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7074
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6588
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6901.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8737.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6588
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8100
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6922.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 7020
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5940
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9180
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6922.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9180
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5940
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6588
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8251.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8251.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7884
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5940
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6588
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6588
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6901.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9180
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1944
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8856
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6588
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6588
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6922.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7884
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7030.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8953.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6588
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6901.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5940
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8251.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9180
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6922.8
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9180
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8737.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7030.8
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9504
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10800,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2948.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 7074
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7030.8
            }
          ]
        }
      ]
    },
    {
      "description": "GRAFT 7 X 10CM FISH-SKIN OMEGA3 SURGICLOSE PER SQ CM",
      "code_information": [
        {
          "code": "SUP-50205S03D0D",
          "type": "CDM"
        },
        {
          "code": "Q4158",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 147.09,
          "discounted_cash": 95.61,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 112.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.03
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 81.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 81.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 95.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 110.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.03
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.03
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 121.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.96
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 112.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.03
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 129.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 112.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 112.38
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.03
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 95.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.9
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.38
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.96
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 81.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 147.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.96
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 95.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 121.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 119
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 95.61
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.03
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 81.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 95.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.96
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 129
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 112.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 119
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 110.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 95.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.03
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 97.08
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 110.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 112.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 121.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 92.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.43
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 107.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 94.43
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 129
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 147.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.03
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 80.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 120.61
            }
          ]
        }
      ]
    },
    {
      "description": "GRAFT 250CM2 FISH-SKIN MESHED 2:1 OMEGA3 SURGICLOSE PER SQ CM",
      "code_information": [
        {
          "code": "SUP-50205N24D0D",
          "type": "CDM"
        },
        {
          "code": "Q4158",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 142.32,
          "discounted_cash": 92.51,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 108.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 108.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.97
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 38.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 142.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 78.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 106.74
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.97
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.97
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 115.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 78.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 116.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 92.65
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.97
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 103.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 106.74
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 106.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 115.14
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 116.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 116.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 103.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.37
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 89.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 103.89
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.37
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 116.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 116.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 92.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.97
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 78.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 116.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 89.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 108.73
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 89.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 78.99
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 92.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 89.95
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 92.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 117.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.37
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 103.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 92.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 108.73
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.97
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.97
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 124.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 120.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 78.28
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 89.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 89.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 89.95
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 93.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 108.73
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 125.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 89.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 116.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 117.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 116.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 91.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 103.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 103.89
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 142.32,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 124.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 108.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 117.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 92.65
            }
          ]
        }
      ]
    },
    {
      "description": "GRAFT 95CM2 FISH-SKIN MICROGRAFT OMEGA 3 SURGICLOSE PER SQ CM",
      "code_information": [
        {
          "code": "SUP-50205P31D0D",
          "type": "CDM"
        },
        {
          "code": "Q4158",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 129.33,
          "discounted_cash": 84.06,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 83.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 71.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 129.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 106.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 104.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 104.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 83.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 83.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 98.81
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 81.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 106.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 84.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 84.19
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 94.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 71.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 81.74
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 83.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 98.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 81.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 81.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 85.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 107.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 106.05
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 83.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 71.13
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.93
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 84.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 83.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 83.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 84.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 71.13
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 83.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.93
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 94.41
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 106.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 83.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 83.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 94.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 71.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 98.81
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 94.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 107.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 106.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 83.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.93
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.93
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 94.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 113.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 71.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 71.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 106.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 81.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 81.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 98.81
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 113.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 98.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 71.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.93
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 107.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 106.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 35.31
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 84.06
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 94.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 71.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 84.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 106.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 109.93
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 71.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 98.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 81.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 81.74
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 113.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 129.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 71.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 83.03
            }
          ]
        }
      ]
    },
    {
      "description": "FILTER ULPA SMOKE EVACUATOR NEPTUE 2 SAFEAIR",
      "code_information": [
        {
          "code": "SUP-0703-040-000",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 185,
          "discounted_cash": 120.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 151.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 116.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 138.75
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 122.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 151.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 141.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 120.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 120.44
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 116.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 120.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 116.18
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 153.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 149.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 120.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 101.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 138.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 116.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 116.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 120.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 102.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 101.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 116.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 116.18
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 120.25
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 162.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 116.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 120.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 116.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 141.34
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 50.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 120.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 101.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 101.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 135.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 116.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 116.92
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 102.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 102.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 151.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 151.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 149.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 101.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 141.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 153.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 116.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 141.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 138.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 116.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 153.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 135.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 116.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 116.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 135.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 151.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 141.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.77
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 135.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 185
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 116.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 162.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 116.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 120.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 162.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 141.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 102.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 135.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 151.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 116.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 151.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 135.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 116.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 101.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 101.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 185,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.77
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 118.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 151.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 120.44
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 116.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 116.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 157.25
            }
          ]
        }
      ]
    },
    {
      "description": "SUTURE 5-0 36IN PROLENE 8720ZH C-1",
      "code_information": [
        {
          "code": "SUP-8720ZH",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11.97,
          "discounted_cash": 7.78,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 11.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.79
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 7.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 9.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.74
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 10.53
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.74
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.97,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.15
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 7.52
            }
          ]
        }
      ]
    },
    {
      "description": "CATH 3.5MM BRONCHOSCOPE FULLY ARTICULATING REPOSE/8",
      "code_information": [
        {
          "code": "SUP-490305",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2925,
          "discounted_cash": 1901.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1877.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2135.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1904.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2486.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1608.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1848.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1623.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1836.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2366.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2234.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2135.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2234.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2398.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2135.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1608.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2234.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2193.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2398.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2398.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1848.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1608.75
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 798.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2398.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2234.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2424.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1836.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1848.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1877.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2398.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2486.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2486.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2424.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1848.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2486.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2234.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1836.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1836.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2565.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1877.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1877.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1877.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2565.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1877.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1904.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2486.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2486.25
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1930.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2135.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1898.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1904.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1836.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1898.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1877.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1608.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1877.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1877.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2135.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1848.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1623.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2398.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2486.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1836.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1877.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2193.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1623.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2398.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1836.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2366.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1608.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2486.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1623.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1836.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2135.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2925,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1904.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1904.18
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2486.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1836.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1836.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2925
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1836.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1848.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2486.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1877.85
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1901.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1848.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2234.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1608.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1836.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1898.33
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2574
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2398.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1836.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1848.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2193.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1877.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1608.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2424.83
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2486.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2486.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1898.33
            }
          ]
        }
      ]
    },
    {
      "description": "SYSTEM GENERATOR PULSE IMPLANTABLE REACTIV8",
      "code_information": [
        {
          "code": "SUP-5100",
          "type": "CDM"
        },
        {
          "code": "C1767",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 40800,
          "discounted_cash": 26520,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26152.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31171.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 26520
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22644
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 24888
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34680
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 24888
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 24888
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 33007.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30600
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26152.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 26071.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 26071.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26560.8
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 26724
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26152.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 26724
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22440
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22440
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 24888
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 24888
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 24888
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31171.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26152.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29784
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33823.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26560.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26152.8
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29784
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 26724
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33456
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 8935.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34680
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33823.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 24888
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 26724
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31171.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29784
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29784
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31171.2
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 11138.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26560.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 26724
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 26724
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 35781.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 40800
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 24888
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 26724
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34680
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22440
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22644
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22644
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33823.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33456
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33456
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33456
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 24888
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 7344
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22440
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26152.8
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34680
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22644
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 24888
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33456
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 24888
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34680
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34680
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34680
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 26928
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22440
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22440
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 35781.6
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 35904
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26152.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26152.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34680
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33456
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34680
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26152.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34680
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 26071.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34680
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31171.2
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29784
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 24888
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34680
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26152.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30600
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29784
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33456
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33456
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 7344
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 26724
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30600
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 24888
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26560.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26560.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34680
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26152.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 26152.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 26071.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 33007.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31171.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34680
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22440
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40800,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "LEAD 45CM STIMULATION AND SUTURE SLEEVE REACTIV8",
      "code_information": [
        {
          "code": "SUP-8145",
          "type": "CDM"
        },
        {
          "code": "C1778",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8100,
          "discounted_cash": 5265,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5192.1
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5305.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6642
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5175.9
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6642
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5175.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4455
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7128
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4941
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6885
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4941
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5305.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6885
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6075
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6552.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4495.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4941
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6552.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6885
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5192.1
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5273.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5913
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5305.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6642
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6642
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5273.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5265
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6885
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6642
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4941
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4495.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6642
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5305.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1458
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5192.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5192.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5175.9
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2211.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5192.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6885
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4941
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4455
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4495.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5913
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6885
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4495.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4941
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4941
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6188.4
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5346
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6188.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5913
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4941
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4455
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6885
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4455
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6714.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5192.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5913
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6188.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5305.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7103.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5273.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5175.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5273.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6188.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1458
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6075
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7103.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6885
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6885
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6885
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6714.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6714.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4941
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5273.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5192.1
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6885
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4455
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5192.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4941
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6885
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6885
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4455
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1773.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5192.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6188.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5913
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6885
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5305.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8100
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6642
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4941
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5305.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6188.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5913
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6642
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4941
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4455
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6075
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5192.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4941
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5192.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5305.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5192.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8100,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 5 X 100MM CAN VAR ANG LOCK STERL OPTILINK",
      "code_information": [
        {
          "code": "SUP-42.231.700S",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 975,
          "discounted_cash": 633.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 624.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 624.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 638.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 623.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 828.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 536.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 828.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 624.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 624.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 828.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 788.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 634.73
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 731.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 541.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 638.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 744.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 638.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 594.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 744.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 799.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 634.73
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 975,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 975,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 828.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 536.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 594.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 624.98
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 828.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 623.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 788.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 541.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 541.13
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 744.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 744.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 828.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 799.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 634.73
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 975,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 858
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 266.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 638.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 536.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 536.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 638.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 624.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 828.75
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 828.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 594.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 594.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 594.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 594.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 594.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 855.08
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 828.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 711.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 711.75
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 808.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 799.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 624.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 711.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 828.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 536.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 638.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 711.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 594.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 536.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 638.63
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 828.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 828.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 541.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 799.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 624.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 711.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 711.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 594.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 623.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 808.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 594.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 624.98
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 975
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 799.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 855.08
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 744.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 624.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 594.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 624.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 731.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 623.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 624.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 594.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 634.73
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 744.9
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 536.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 638.63
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 828.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 799.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 828.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 731.25
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 643.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 808.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 634.73
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 975,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 975,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 975,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 975,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 633.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 799.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 799.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 594.75
            }
          ]
        }
      ]
    },
    {
      "description": "PROBE 2.3MM 300CM FLEXIBLE W/ FILTER FIAPC",
      "code_information": [
        {
          "code": "SUP-20132-216",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 825,
          "discounted_cash": 536.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 529.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 630.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 457.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 518.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 701.25
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 225.23
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 536.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 723.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 683.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 535.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 529.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 529.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 701.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 529.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 630.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 630.3
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 701.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 602.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 518.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 521.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 676.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 535.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 521.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 521.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 529.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 529.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 529.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 602.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 537.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 521.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 701.25
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 701.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 602.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 701.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 723.53
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 701.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 630.3
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 618.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 518.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 521.4
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 544.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 457.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 676.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 518.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 618.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 676.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 457.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 683.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 529.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 825
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 683.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 676.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 518.1
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 825,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 726
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 602.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 457.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 521.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 535.43
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 701.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 529.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 701.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 618.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 676.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 537.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 529.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 602.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 701.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 453.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 602.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 518.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 529.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 521.4
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 701.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 518.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 518.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 518.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 537.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 518.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 518.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 667.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 701.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 453.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 453.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 453.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 518.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 535.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 667.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 521.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 630.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 630.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 676.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 676.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 518.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 537.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 453.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 676.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 529.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 537.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 453.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 453.75
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter 100% Silicone 16 Fr 5 Cc Peco Cardinal",
      "code_information": [
        {
          "code": "PX-CH-PCPF5816",
          "type": "CDM"
        },
        {
          "code": "A4344",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.57,
          "discounted_cash": 4.27,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Syringe Only 10cc Luer Lock",
      "code_information": [
        {
          "code": "PX-CH-TESS10L",
          "type": "CDM"
        },
        {
          "code": "A4657",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.26,
          "discounted_cash": 0.17,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.26,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 0.9,
          "discounted_cash": 0.58,
          "payers_information": [
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.9,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.74
            }
          ]
        }
      ]
    },
    {
      "description": "Barrier Wipe Skin-Prep",
      "code_information": [
        {
          "code": "PX-CH-UN4204-00",
          "type": "CDM"
        },
        {
          "code": "A5120",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.18,
          "discounted_cash": 0.12,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.18,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.15
            }
          ]
        }
      ]
    },
    {
      "description": "HC Dialysis Circuit Intro Needle/Cath W Tba Peripheral W Img",
      "code_information": [
        {
          "code": "PX-36100837",
          "type": "CDM"
        },
        {
          "code": "36902",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 16652,
          "discounted_cash": 10823.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10690.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12155.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10840.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16652,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 16652,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10840.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9158.6
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 10990.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10690.58
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14154.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16652,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13654.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10690.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10690.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9158.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13654.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16652,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16652,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16652,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14154.2
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13471.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10690.58
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13471.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9158.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 16652
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13654.64
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 14653.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12155.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16652,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12155.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16652,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14154.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10524.06
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10840.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13654.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12722.13
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 16652
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4546
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14154.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14154.2
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 3646.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 16652
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12489
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16652,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 16652
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12155.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10840.45
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10690.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10690.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16652,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16652,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10690.58
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14154.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12722.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14154.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10690.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13804.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12155.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16652,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16652,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16652,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 2997.36
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14154.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14603.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10524.06
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12722.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16652,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16652,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 2997.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12155.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14154.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9158.6
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 16652,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10524.06
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12489
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10690.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12722.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9158.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9158.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14154.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16652,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10690.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10524.06
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4988.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 16652
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14154.2
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5127.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 16652,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14154.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10840.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13654.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16652,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14154.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9158.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13804.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13654.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10690.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12722.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10524.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10524.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12489
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13654.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13654.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14603.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14154.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13804.51
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 10823.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12722.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10524.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10524.06
            }
          ]
        }
      ]
    },
    {
      "description": "HC Injection Dx or Ther Epidur or Subarach Cer or Thor WO Img",
      "code_information": [
        {
          "code": "PX-36100849",
          "type": "CDM"
        },
        {
          "code": "62320",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7799,
          "discounted_cash": 5069.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5006.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5958.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4289.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4289.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5077.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5958.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5006.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5077.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6629.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4928.97
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5849.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6629.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5006.96
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5147.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6309.39
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6629.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6395.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5693.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5693.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5006.96
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5069.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5958.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6839.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4928.97
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6629.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5006.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6839.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6465.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6395.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6629.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4928.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6395.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5006.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5693.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5849.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5849.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6629.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6465.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5006.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4928.97
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6629.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4289.45
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6863.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5006.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4289.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5693.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5006.96
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6629.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4928.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6629.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5077.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4928.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5958.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5958.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2129.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4928.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6309.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6395.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5006.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6629.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6395.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6395.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4289.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5693.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7799,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5693.27
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6629.15
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6629.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6395.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "OP SURG "
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6395.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5006.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4928.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5077.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5077.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4289.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4289.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5958.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5006.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7799,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6465.37
            }
          ]
        }
      ]
    },
    {
      "description": "HC Injection Dx or Ther Epidur or Subarach Lum or Sacr WO Img",
      "code_information": [
        {
          "code": "PX-36100851",
          "type": "CDM"
        },
        {
          "code": "62322",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6601,
          "discounted_cash": 4290.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5043.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4818.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5472.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6601,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5043.16
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4237.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6601,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6601,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5610.85
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1445.62
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4237.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4171.83
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4237.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5610.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5412.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4950.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4818.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6601,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5043.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4950.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5412.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3630.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3630.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4818.73
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5610.85
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4356.66
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5610.85
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5610.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3630.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6601,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6601,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5043.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6601,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5610.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5043.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5472.23
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5610.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6601,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5610.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3630.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4818.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6601,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3630.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5340.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4171.83
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 620.36,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6601,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5610.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3630.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4237.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4818.73
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5610.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6601,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4171.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4297.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6601,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6601,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6601,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4290.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4297.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4237.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5789.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5340.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6601,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5412.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5412.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6601,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4237.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4297.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4171.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5789.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5043.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4237.84
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5610.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5472.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4171.83
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1188.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4950.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3630.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5412.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4237.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4171.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4237.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5610.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4237.84
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5610.85
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6601,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1188.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5412.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5412.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6601,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4171.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4171.83
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5610.85
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1802.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4237.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4237.84
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4297.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5412.82
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5808.88
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6601,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4297.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6601,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4818.73
            }
          ]
        }
      ]
    },
    {
      "description": "HC Injection Dx or Ther Epidur or Subarach Lum or Sacr W Img",
      "code_information": [
        {
          "code": "PX-36100852",
          "type": "CDM"
        },
        {
          "code": "62323",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7281,
          "discounted_cash": 4732.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4674.4
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4674.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6188.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5562.68
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6188.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1310.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5562.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4004.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4674.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4601.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5890.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5970.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4739.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4674.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4004.55
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7281,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5315.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5970.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4674.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4674.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4004.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6385.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5460.75
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1594.54
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7281,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5562.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6188.85
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 633.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4004.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5970.42
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6188.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5970.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4004.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4601.59
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4004.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6035.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4674.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6188.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6035.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5315.13
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4805.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6188.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4732.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5562.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4601.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4739.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5890.33
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5562.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6188.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6188.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4674.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6188.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5970.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5970.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6188.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6188.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5315.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4674.4
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7281,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5970.42
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6188.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5970.42
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5460.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4674.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4674.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6385.44
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4601.59
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1987.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "estimated_amount": 3580
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6035.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6188.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4674.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4739.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4004.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5315.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4739.93
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6188.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4601.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5315.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5562.68
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1310.58
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4739.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4601.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4601.59
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5315.13
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 603.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6407.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5460.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4601.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7281,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Mod Sed Same Phys as Proc 1st 15 Min",
      "code_information": [
        {
          "code": "PX-37000011",
          "type": "CDM"
        },
        {
          "code": "99152",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 599,
          "discounted_cash": 389.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 384.56
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 599,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 491.18
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 384.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 384.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 329.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 384.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 384.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 491.18
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 389.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 329.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 329.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 496.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 437.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 599,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 525.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 496.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 329.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 437.27
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 457.64
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 389.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 437.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 457.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 332.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 491.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 599,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 378.57
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 395.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 384.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 329.45
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 599,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 329.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 332.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 389.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 437.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 378.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 449.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 491.18
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 389.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 527.12
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 457.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 491.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 437.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 332.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 599
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 457.64
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 599,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 599,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 384.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 389.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 329.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 437.27
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 163.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 457.64
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 384.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 384.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 457.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 384.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 449.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 378.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 378.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 332.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 496.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 484.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 491.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 384.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 491.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 449.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 389.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 484.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 491.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 378.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 599,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 599,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 378.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 378.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 525.32
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 384.56
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 509.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 378.57
            }
          ]
        }
      ]
    },
    {
      "description": "HC Pt Re-Eval",
      "code_information": [
        {
          "code": "PX-42400008",
          "type": "CDM"
        },
        {
          "code": "97164",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 277,
          "discounted_cash": 180.05,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 229.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 180.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 227.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 175.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 277,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 175.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 202.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 211.63
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.35
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 277,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 277,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 202.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 229.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 211.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 180.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 277,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 202.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 242.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.45
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 202.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 211.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 175.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 277,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 153.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 277,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 175.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 277,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.83
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 75.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 175.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 180.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 277,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 202.21
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 211.63
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 224.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 211.63
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 182.82
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 175.06
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 229.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 277,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 227.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 277,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 153.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 227.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 277,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 277,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 277,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 277,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.45
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 277,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 242.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 211.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 207.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 180.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 224.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 202.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 153.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.45
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 277,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 207.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 277
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 180.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 277,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 243.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.83
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 277,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 277,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 207.75
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 69.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 227.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 227.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 152.35
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 227.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 277,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 175.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 227.14
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 227.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 277,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 175.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 153.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 177.83
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 180.05
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 235.45
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 277,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 277,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Mask Surgical Earloop Cardinal Health Brand",
      "code_information": [
        {
          "code": "PX-CH-A1-AT7511",
          "type": "CDM"
        },
        {
          "code": "A4928",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.6,
          "discounted_cash": 0.39,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Gauze Sponge Non-Sterile Cardinal Health Brand",
      "code_information": [
        {
          "code": "PX-CH-A1-CHH4412NS",
          "type": "CDM"
        },
        {
          "code": "A6216",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.6,
          "discounted_cash": 0.39,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter Lubricath Coude 20 Fr 30 Cc",
      "code_information": [
        {
          "code": "PX-CH-BA0103L20",
          "type": "CDM"
        },
        {
          "code": "A4340",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 31.48,
          "discounted_cash": 20.46,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 26.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 27.61
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 31.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.76
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 27.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 26.1
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.05
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 26.1
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 25.47
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.76
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.05
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.31
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.31
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.76
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.98
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 27.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.81
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 20.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 24.05
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 20.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 31.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 25.47
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Pouch Little Ones",
      "code_information": [
        {
          "code": "PX-CH-CV4116-40",
          "type": "CDM"
        },
        {
          "code": "A4419",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.35,
          "discounted_cash": 1.53,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.29
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.49
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.29
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.95
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.35
            }
          ]
        }
      ]
    },
    {
      "description": "Pleurx Vacuum Bottle 1000 Ml",
      "code_information": [
        {
          "code": "PX-CH-DB50-7210",
          "type": "CDM"
        },
        {
          "code": "A7048",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 52.67,
          "discounted_cash": 34.24,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.81
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29.23
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 46.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 52.67
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 42.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38.45
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 43.66
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.29
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 39.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 43.66
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 43.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29.23
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.29
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 39.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 14.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 46.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.81
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40.24
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 34.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.29
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 42.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.19
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 33.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29.23
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29.23
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 39.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40.24
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43.19
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 33.81
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 46.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 52.67,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44.77
            }
          ]
        }
      ]
    },
    {
      "description": "\"1 Pc Pre-Cut Cvx 3 / 4 \"\" Stoma Premier Cera Pls\"",
      "code_information": [
        {
          "code": "PX-CH-HO8990",
          "type": "CDM"
        },
        {
          "code": "CUSTOM",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 17.54,
          "discounted_cash": 11.4,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.09
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.42
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 17.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.73
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 11.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 11.38
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 11.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.02
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 17.54,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 11.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.02
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.91
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 15.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.4
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 11.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 11.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 11.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12.8
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.65
            }
          ]
        }
      ]
    },
    {
      "description": "Kit Spill Special",
      "code_information": [
        {
          "code": "PX-CH-MZDYKD10318",
          "type": "CDM"
        },
        {
          "code": "CUSTOM",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.28,
          "discounted_cash": 3.43,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.43
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.28,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.93
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.9
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.93
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.44
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.34
            }
          ]
        }
      ]
    },
    {
      "description": "Tongue Depressor Sterile",
      "code_information": [
        {
          "code": "PX-CH-MZMDS202075",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.05,
          "discounted_cash": 0.03,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            }
          ]
        }
      ]
    },
    {
      "description": "Drainage Suction System 1000ml Tru-Close for Nephrostomy",
      "code_information": [
        {
          "code": "PX-CH-MZ-TCS1000",
          "type": "CDM"
        },
        {
          "code": "A7048",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 83.96,
          "discounted_cash": 54.57,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.9
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 55.41
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 73.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 67.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 73.63
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 54.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 64.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 64.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 53.06
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 22.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 64.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 54.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 73.63
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 46.6
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 53.06
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.29
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 62.97
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 64.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 83.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 53.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 54.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.37
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 46.6
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 62.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 53.06
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 54.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 69.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 69.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 53.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 62.97
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 64.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 53.06
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 67.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 69.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 54.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 46.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 53.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.18
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 68.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 46.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 71.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 64.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 53.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 53.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 46.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 61.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 83.96,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter Silicone Elastomer 30 Fr 5cc Peco Cardinal",
      "code_information": [
        {
          "code": "PX-CH-PCPF6530",
          "type": "CDM"
        },
        {
          "code": "A4338",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.34,
          "discounted_cash": 0.87,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.37
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.34,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Attachment Device Foley Leg Strap Latex-Free",
      "code_information": [
        {
          "code": "PX-CH-PM606",
          "type": "CDM"
        },
        {
          "code": "A4334",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.06,
          "discounted_cash": 3.29,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.06,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Test Strips Coaguchek Xs Pt Roche",
      "code_information": [
        {
          "code": "PX-CH-ROC04625315160",
          "type": "CDM"
        },
        {
          "code": "E1399",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.83,
          "discounted_cash": 5.74,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.41
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.83,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.45
            }
          ]
        }
      ]
    },
    {
      "description": "Ostomy Support Garment Stomasafe Plus Lg/Xlg",
      "code_information": [
        {
          "code": "PX-CH-TYT32160602",
          "type": "CDM"
        },
        {
          "code": "A4367",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 21.28,
          "discounted_cash": 13.83,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 17.22
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 21.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.09
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.81
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 17.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 17.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.45
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 17.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.45
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.09
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 14.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 18.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.26
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 13.83
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 17.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 18.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 18.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Tape Cloth Retention Drsg 4 in X 11 Yards Reliamed",
      "code_information": [
        {
          "code": "PX-CH-ZTDR04",
          "type": "CDM"
        },
        {
          "code": "A4452",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 16.09,
          "discounted_cash": 10.46,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.68
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.68
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 16.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.68
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.93
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.68
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 10.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.68
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.34
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 14.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.09,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.93
            }
          ]
        }
      ]
    },
    {
      "description": "Moisture Barrier Cream Sensi-Care 4 Oz",
      "code_information": [
        {
          "code": "PX-CH-CV3256-14",
          "type": "CDM"
        },
        {
          "code": "A6250",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 15.23,
          "discounted_cash": 9.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.38
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 10.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.12
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.38
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 13.36
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 13.36
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.42
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.12
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.78
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 13.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 12.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 15.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.95
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 9.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 12.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 15.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Foam Drsg Non-Adhesive Hydrofera Blue 4 in X 4 In",
      "code_information": [
        {
          "code": "PX-CH-ADVOHB4414",
          "type": "CDM"
        },
        {
          "code": "A6209",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.49,
          "discounted_cash": 6.82,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.01
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.49
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.23
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.87
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.49,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.01
            }
          ]
        }
      ]
    },
    {
      "description": "Foam Drsg Adhesive Optifoam 4 in Round Fenestrated",
      "code_information": [
        {
          "code": "PX-CH-MZMSC1104Z",
          "type": "CDM"
        },
        {
          "code": "A6215",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.8,
          "discounted_cash": 2.47,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.07
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.09
            }
          ]
        }
      ]
    },
    {
      "description": "Syringe/Needle 3 Cc 25 G X 5/8 in Safety",
      "code_information": [
        {
          "code": "PX-CH-BD305904",
          "type": "CDM"
        },
        {
          "code": "A4208",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.8,
          "discounted_cash": 0.52,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.68
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.52
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Pouch 2 3/4 in New Image Closed End",
      "code_information": [
        {
          "code": "PX-CH-HO18374",
          "type": "CDM"
        },
        {
          "code": "A4419",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.19,
          "discounted_cash": 0.77,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.19,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.01
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 1.14,
          "discounted_cash": 0.74,
          "payers_information": [
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.14
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.14,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.95
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 1.2,
          "discounted_cash": 0.78,
          "payers_information": [
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.76
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.2,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.05
            }
          ]
        }
      ]
    },
    {
      "description": "Gauze Roll Nonsterile Kerlix 4 1/2 in X 4.1 Yds",
      "code_information": [
        {
          "code": "PX-CH-KN1892",
          "type": "CDM"
        },
        {
          "code": "A6443",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.17,
          "discounted_cash": 1.41,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.63
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.9
            }
          ]
        }
      ]
    },
    {
      "description": "HC CT Coronary Calcium Scan Diagnostic",
      "code_information": [
        {
          "code": "PX-35200044",
          "type": "CDM"
        },
        {
          "code": "75571",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 509,
          "discounted_cash": 330.85,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 374.62
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 381.75
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 432.65
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 509,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 331.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 417.38
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 372.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 372.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 432.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 331.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 331.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 374.62
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 279.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 509,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 279.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 421.96
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 432.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 432.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 417.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 509,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 411.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 279.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 374.12
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 432.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 374.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 374.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 388.88
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 447.92
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 432.65
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 279.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 331.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 432.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 331.36
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 372.59
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 81.52,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 509,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 432.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 371.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 446.39
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 374.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 421.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 509,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 411.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 509,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 374.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 374.62
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 279.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 371.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 371.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 371.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 432.65
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 509,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 138.96
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 374.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 417.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 417.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 509,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 432.65
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 509,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 279.95
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 374.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 509,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 509,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 372.59
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 421.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 374.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 374.62
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 509,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 371.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 374.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 417.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 509,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 509,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 374.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 432.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 509
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 388.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 388.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 446.39
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 432.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 509,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 509,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.5,
              "estimated_amount": 374.12
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 371.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 417.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 432.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 388.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 372.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 372.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 432.65
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 335.94
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 381.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 279.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 381.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 417.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 372.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 509,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 509,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 330.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 417.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 509,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 509,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 388.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.6,
              "estimated_amount": 374.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73.2,
              "estimated_amount": 372.59
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 509,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 509,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 509,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 388.88
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 79.31,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "1 Pc Ctf Ext Wear Cvx 5/8 in - 1 5/16 in Sensura",
      "code_information": [
        {
          "code": "PX-CH-CO15695",
          "type": "CDM"
        },
        {
          "code": "A5057",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 12.77,
          "discounted_cash": 8.3,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 11.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 11.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.58
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 12.77
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 11.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.59
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 10.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 12.77,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter Silicone Elastomer 24 Fr 5 Cc",
      "code_information": [
        {
          "code": "PX-CH-BA123524A",
          "type": "CDM"
        },
        {
          "code": "A4338",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.28,
          "discounted_cash": 0.83,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.28,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.98
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 3.17,
          "discounted_cash": 2.06,
          "payers_information": [
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.42
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.56
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.6
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3.17,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Ctf Ext Wear Cvx 5/8 in - 2 in Sensura Flex",
      "code_information": [
        {
          "code": "PX-CH-CO11308",
          "type": "CDM"
        },
        {
          "code": "A4407",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 13.13,
          "discounted_cash": 8.53,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.3
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.58
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.3
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 11.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.3
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.58
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 11.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.77
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.88
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 10.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 11.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 9.85
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 10.77
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 13.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.22
            }
          ]
        }
      ]
    },
    {
      "description": "Enema Set Administration Soap Suds",
      "code_information": [
        {
          "code": "PX-CH-MZDYND70100",
          "type": "CDM"
        },
        {
          "code": "A4458",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.27,
          "discounted_cash": 1.48,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.88
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Transparent Drsg Tegaderm 8 in X 12 in IV Frame",
      "code_information": [
        {
          "code": "PX-CH-3M1629",
          "type": "CDM"
        },
        {
          "code": "A6259",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.84,
          "discounted_cash": 2.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.43
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.93
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.93
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 3.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.43
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 3.84,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Fsed Potassium Serum Plasma or Whole Blood",
      "code_information": [
        {
          "code": "PX-30101217",
          "type": "CDM"
        },
        {
          "code": "84132",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9,
          "discounted_cash": 5.85,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 4.76,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.71,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.71,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.71,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.85,
              "estimated_amount": 17.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            }
          ],
          "minimum": 4.76,
          "maximum": 17.85
        }
      ]
    },
    {
      "description": "HC Fsed Cbc With Diff",
      "code_information": [
        {
          "code": "PX-30500130",
          "type": "CDM"
        },
        {
          "code": "85025",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 31,
          "discounted_cash": 20.15,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.25
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_dollar": 7.77,
              "standard_charge_algorithm": "Includes reimbursement for any outliers.",
              "estimated_amount": 8.16,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.14,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.14,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.14,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 20.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.14,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.59
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 20.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.14,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 31,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.14,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 27.19
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 31,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 25.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.14,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.14,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.14,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.14,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.36,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.05
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.36,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.42
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 25.08
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 31,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.14,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.14,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.14,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.21
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.68
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.14,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 25.08
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 25.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.68
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.59
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.14,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.14,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17.05
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 29.14,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.18
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 27.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.21
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 27.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 25.7
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 11.36,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7.77,
              "estimated_amount": 7.77
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.35
            }
          ],
          "minimum": 7.77,
          "maximum": 29.14
        }
      ]
    },
    {
      "description": "HC Fsed Rsv Antigen Nasal Swab",
      "code_information": [
        {
          "code": "PX-30600317",
          "type": "CDM"
        },
        {
          "code": "87807",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 545,
          "discounted_cash": 354.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 416.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 344.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.13,
              "estimated_amount": 49.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.13,
              "estimated_amount": 49.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 446.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 344.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 299.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 408.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 344.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 397.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 354.8
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 148.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 416.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 397.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 397.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 440.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.13,
              "estimated_amount": 49.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.13,
              "estimated_amount": 49.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.13,
              "estimated_amount": 49.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 299.75
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 354.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 408.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 451.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 344.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 397.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 451.81
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 545,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 354.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 446.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 344.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 479.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 302.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 416.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 354.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.13,
              "estimated_amount": 49.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 299.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 446.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 446.9
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 416.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 440.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.13,
              "estimated_amount": 49.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 408.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.13,
              "estimated_amount": 49.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.13,
              "estimated_amount": 49.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 299.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 545
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 344.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 397.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 451.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 299.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 446.9
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 359.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 446.9
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.13,
              "estimated_amount": 49.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.13,
              "estimated_amount": 49.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 302.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.13,
              "estimated_amount": 49.13
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 299.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 397.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 354.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 446.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 354.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.13,
              "estimated_amount": 49.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 349.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.13,
              "estimated_amount": 49.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 416.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 344.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.13,
              "estimated_amount": 49.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 302.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 299.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.13,
              "estimated_amount": 49.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 416.38
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 463.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 344.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 477.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 446.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.13,
              "estimated_amount": 49.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 302.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 477.97
            }
          ],
          "minimum": 49.13,
          "maximum": 49.13
        }
      ]
    },
    {
      "description": "Central Line Dressing Tray W/2% Chg",
      "code_information": [
        {
          "code": "PX-CH-AC68734",
          "type": "CDM"
        },
        {
          "code": "A4221",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 11.05,
          "discounted_cash": 7.18,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.39
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 9.16
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.72
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.98
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 11.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 7.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 8.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 11.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 8.29
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 9.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 6.08
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 7.91,
          "discounted_cash": 5.14,
          "payers_information": [
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.16
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.77
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.93
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 7.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.39
            }
          ]
        }
      ]
    },
    {
      "description": "Foam Drsg Adhesive Border Mepilex 3 in X 3 In",
      "code_information": [
        {
          "code": "PX-CH-SM295200",
          "type": "CDM"
        },
        {
          "code": "A6212",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.24,
          "discounted_cash": 3.41,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.88
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.88
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.24,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.34
            }
          ]
        }
      ]
    },
    {
      "description": "PALIPERIDONE ER 1.5 MG TABLET,EXTENDED RELEASE 24 HR",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-100011",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9,
          "discounted_cash": 5.85,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
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              "standard_charge_percentage": 66,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            }
          ]
        }
      ]
    },
    {
      "description": "FLECAINIDE 50 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-10043",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.85,
          "discounted_cash": 3.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
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              "estimated_amount": 3.76
            },
            {
              "payer_name": "ANTHEM [335]",
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              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "CIGNA [370]",
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              "estimated_amount": 4.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.81
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            }
          ]
        }
      ]
    },
    {
      "description": "ACETAMINOPHEN 325 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-101",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.05,
          "discounted_cash": 0.03,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            }
          ]
        }
      ]
    },
    {
      "description": "HYDROXYCHLOROQUINE 200 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-10235",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.7,
          "discounted_cash": 4.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            }
          ]
        }
      ]
    },
    {
      "description": "HYDROXYUREA 500 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-10236",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.6,
          "discounted_cash": 4.29,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.79
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.28
            }
          ]
        }
      ]
    },
    {
      "description": "BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM",
      "drug_information": {
        "unit": "15",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-1031",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 57.1,
          "discounted_cash": 37.11,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 31.69
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 15.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 50.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.09
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.41
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 37.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 47.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 31.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 37.06
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 50.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.66
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 46.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.86
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 50.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 57.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 47.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 47.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.86
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 37.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 37.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 37.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.09
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 42.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 37.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 36.09
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 57.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 42.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 31.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 31.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.82
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 37.17
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 42.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 46.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.54
            }
          ]
        }
      ]
    },
    {
      "description": "LIOTHYRONINE 5 MCG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-10443",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.1,
          "discounted_cash": 3.96,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.66
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.97
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.19
            }
          ]
        }
      ]
    },
    {
      "description": "LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-10454",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.55,
          "discounted_cash": 3.61,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.52
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.49
            }
          ]
        }
      ]
    },
    {
      "description": "CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "100",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-108072",
          "type": "CDM"
        },
        {
          "code": "J9055",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6601.3,
          "discounted_cash": 4290.84,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4238.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3439.33,
              "estimated_amount": 3439.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5413.07
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1188.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4238.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4818.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5789.34
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4297.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5340.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5611.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5043.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3439.33,
              "estimated_amount": 3439.33
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5611.11
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5611.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4238.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4297.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4297.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4099.2,
              "estimated_amount": 4099.2
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4099.2,
              "estimated_amount": 4099.2
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5611.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3630.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4818.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5413.07
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5611.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4238.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5789.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4172.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5472.48
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5611.11
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1512.36,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4297.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4099.2,
              "estimated_amount": 4099.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4238.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3630.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4818.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4172.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4238.03
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1445.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4172.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5472.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5413.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4818.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5043.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5043.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4238.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4950.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5413.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5413.07
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4290.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4172.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4099.2,
              "estimated_amount": 4099.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4099.2,
              "estimated_amount": 4099.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5611.11
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5611.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3630.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3630.72
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4818.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1802.15
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4238.03
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5809.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5413.07
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3439.33,
              "estimated_amount": 3439.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4172.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5413.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5340.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4172.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5611.11
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4356.86
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5611.11
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6601.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5043.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5043.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4099.2,
              "estimated_amount": 4099.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5413.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4172.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4099.2,
              "estimated_amount": 4099.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6601.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4818.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3439.33,
              "estimated_amount": 3439.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5472.48
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4950.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4099.2,
              "estimated_amount": 4099.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4099.2,
              "estimated_amount": 4099.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5611.11
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4950.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4238.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4238.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5611.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3439.33,
              "estimated_amount": 3439.33
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6601.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5043.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4172.02
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4099.2,
              "estimated_amount": 4099.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4099.2,
              "estimated_amount": 4099.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4099.2,
              "estimated_amount": 4099.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5611.11
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1188.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3630.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4099.2,
              "estimated_amount": 4099.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4099.2,
              "estimated_amount": 4099.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4297.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4238.03
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1440.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3630.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3630.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4099.2,
              "estimated_amount": 4099.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5611.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4099.2,
              "estimated_amount": 4099.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4238.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4099.2,
              "estimated_amount": 4099.2
            }
          ],
          "minimum": 3439.33,
          "maximum": 4099.2
        }
      ]
    },
    {
      "description": "LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK",
      "drug_information": {
        "unit": "100",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-108119",
          "type": "CDM"
        },
        {
          "code": "J1956",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 66.75,
          "discounted_cash": 43.39,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.85
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 44.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.49,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.24,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.74
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.24,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.24,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.85
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.24,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.24,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.49,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.24,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.74
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.24,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.24,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.24,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.74
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 58.54
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.24,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.24,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.71
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 58.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.73
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 58.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 18.22
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.24,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.24,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 43.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 50.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.73
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.24,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.19
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.24,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.49,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.49,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.85
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.24,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.49,
              "estimated_amount": 4.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 42.19
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.71
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.24,
              "estimated_amount": 6.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 43.45
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 66.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 55.34
            }
          ],
          "minimum": 4.49,
          "maximum": 6.24
        }
      ]
    },
    {
      "description": "AMIKACIN 1,000 MG/4 ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "4",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-108133",
          "type": "CDM"
        },
        {
          "code": "J0278",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 54,
          "discounted_cash": 35.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.26
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 47.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.13
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 43.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.13
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 47.36
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 35.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 14.74
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 54,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.13
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 47.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.12,
              "estimated_amount": 20.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.12,
              "estimated_amount": 20.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.12,
              "estimated_amount": 20.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.12,
              "estimated_amount": 20.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.28
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.9,
              "estimated_amount": 20.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.42
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 43.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.12,
              "estimated_amount": 20.12
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.42
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.9
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 54,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 20.12,
          "maximum": 20.9
        }
      ]
    },
    {
      "description": "ROFLUMILAST 500 MCG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-109401",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.25,
          "discounted_cash": 6.66,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.02
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.41
            }
          ]
        }
      ]
    },
    {
      "description": "PHENYTOIN SODIUM EXTENDED 30 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-11019",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.8,
          "discounted_cash": 5.72,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.53
            }
          ]
        }
      ]
    },
    {
      "description": "FIDAXOMICIN 200 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-110360",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 357.7,
          "discounted_cash": 232.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 273.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 357.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 232.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 224.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 261.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 226.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 313.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 261.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 293.31
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 314.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 196.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 261.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 296.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 273.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 313.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 293.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 224.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 224.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 224.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 224.64
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 293.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 226.07
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 357.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 196.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 261.12
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 196.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 296.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 273.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 226.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 232.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 198.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 296.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 293.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 224.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 196.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 226.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 268.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 226.07
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.05
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 268.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 196.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 261.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 224.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.64
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 198.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 226.07
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 268.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 261.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 198.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 232.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 224.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 224.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 273.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 293.31
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 97.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.64
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 232.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 232.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 232.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 232.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 232.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 224.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 224.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 224.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 198.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 273.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 293.31
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 236.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.64
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 232.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 289.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 224.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 196.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 293.31
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 289.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 226.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 232.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.64
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 229.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 273.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 226.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 196.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 304.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 293.31
            }
          ]
        }
      ]
    },
    {
      "description": "LURASIDONE 20 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-113587",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 120.9,
          "discounted_cash": 78.58,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 67.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 97.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 75.93
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 78.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 75.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 75.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 75.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 75.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 75.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 106.03
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 120.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 75.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 78.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 75.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 75.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 67.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 100.23
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 100.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 99.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 99.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 97.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 78.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 78.71
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 78.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 106.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 67.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 99.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 78.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 75.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 90.68
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 67.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 75.93
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.41
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 100.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 78.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 78.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 99.14
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 90.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 78.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 90.68
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 102.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 92.37
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 33.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 75.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 99.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 76.41
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 79.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 78.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 88.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 99.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 99.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 99.14
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 106.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 120.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 75.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 66.5
            }
          ]
        }
      ]
    },
    {
      "description": "TERBUTALINE 2.5 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-11508",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.6,
          "discounted_cash": 4.94,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.6
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.46
            }
          ]
        }
      ]
    },
    {
      "description": "LINACLOTIDE 145 MCG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-117352",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 56.75,
          "discounted_cash": 36.89,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 56.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 36.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.24
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 42.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 42.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 56.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 49.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.24
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 36.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 49.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 31.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 47.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.87
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.87
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 42.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 31.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 47.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 31.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 36.83
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 37.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 31.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.94
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 31.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 49.77
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 15.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 45.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 45.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.43
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 48.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 36.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 35.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 41.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 36.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 47.05
            }
          ]
        }
      ]
    },
    {
      "description": "CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-119149",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 104.1,
          "discounted_cash": 67.66,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.83
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 67.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 67.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.37
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 104.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.36
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 78.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.36
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 57.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 57.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 67.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.99
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 28.42
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 68.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 84.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.36
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 78.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.37
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.36
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 86.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.79
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 67.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 86.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.53
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 91.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 57.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 86.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 57.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 91.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 91.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 67.56
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 84.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 104.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 78.08
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 46.5,
          "discounted_cash": 30.22,
          "payers_information": [
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 25.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 40.78
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 46.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 30.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 38.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 34.88
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 46.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 37.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 40.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 34.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 38.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 25.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 25.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 30.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.27
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 34.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 37.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.13
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 12.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 25.81
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 40.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 30.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.39
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 30.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 38.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 30.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 30.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.39
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 39.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 39.53
            }
          ]
        }
      ]
    },
    {
      "description": "CARBOXYMETHYLCELLULOSE SODIUM 0.5 % EYE DROPS",
      "drug_information": {
        "unit": "15",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-122130",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.75,
          "discounted_cash": 5.04,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.42
            }
          ]
        }
      ]
    },
    {
      "description": "DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE",
      "drug_information": {
        "unit": "25",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-124729",
          "type": "CDM"
        },
        {
          "code": "J3490",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 71.6,
          "discounted_cash": 46.54,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 62.79
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.25
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 59.36
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.86
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 46.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 46.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 19.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 59.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 57.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.7
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 46.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.97
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 47.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 46.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 53.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 46.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 57.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.86
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 53.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 59.36
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 62.79
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.97
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.97
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 53.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.25
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.97
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 46.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 60.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 63.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 54.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 45.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 71.6,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SYRINGE",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-124935",
          "type": "CDM"
        },
        {
          "code": "J1050",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 148.95,
          "discounted_cash": 96.82,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 216,
              "estimated_amount": 216
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 40.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 111.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 122.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 120.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 130.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.51,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 123.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.92
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 94.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 216,
              "estimated_amount": 216
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 216,
              "estimated_amount": 216
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 94.14
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 120.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.51,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 123.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 216,
              "estimated_amount": 216
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.97
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 122.14
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.73
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.61
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 111.71
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 96.82
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.51,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.51,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 130.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 216,
              "estimated_amount": 216
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 216,
              "estimated_amount": 216
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 98.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 122.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 113.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 111.71
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 216,
              "estimated_amount": 216
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 123.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 122.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 113.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 94.14
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.61
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 122.14
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 94.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 122.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 216,
              "estimated_amount": 216
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 94.14
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 131.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 216,
              "estimated_amount": 216
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 122.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 94.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 216,
              "estimated_amount": 216
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.61
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 94.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 216,
              "estimated_amount": 216
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 122.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 216,
              "estimated_amount": 216
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 216,
              "estimated_amount": 216
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.61
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.51,
              "estimated_amount": 3.51
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 113.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 216,
              "estimated_amount": 216
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.73
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 148.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 113.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 113.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 216,
              "estimated_amount": 216
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 113.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 126.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 94.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 216,
              "estimated_amount": 216
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 216,
              "estimated_amount": 216
            }
          ],
          "minimum": 3.51,
          "maximum": 216
        }
      ]
    },
    {
      "description": "CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-1262",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 104,
          "discounted_cash": 67.6,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.31
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.73
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 28.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 67.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 67.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 104
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 67.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 84.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 57.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.28
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 57.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 57.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 86.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 86.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 84.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 91.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 78
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 68.64
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 104,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 67.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.31
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 86.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.77
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 57.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 67.5
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 91.52
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.4
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 75.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 91.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.73
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 66.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.31
            }
          ]
        }
      ]
    },
    {
      "description": "MEPERIDINE (PF) 25 MG/ML INJECTION SYRINGE",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-128022",
          "type": "CDM"
        },
        {
          "code": "J2175",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 62.2,
          "discounted_cash": 40.43,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.52
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 51.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 41.05
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.41
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.15,
              "estimated_amount": 16.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.93
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 46.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 50.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 50.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 54.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.15,
              "estimated_amount": 16.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 51.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.93
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.31
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.15,
              "estimated_amount": 16.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 51.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.15,
              "estimated_amount": 16.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 54.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.49
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 40.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.41
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.49
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 45.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 16.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.15,
              "estimated_amount": 16.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 54.55
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 34.21
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 46.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 39.31
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 46.65
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 62.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 51
            }
          ],
          "minimum": 16.15,
          "maximum": 17.67
        }
      ]
    },
    {
      "description": "ZINC OXIDE 40 % TOPICAL OINTMENT",
      "drug_information": {
        "unit": "57",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-130359",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3.2,
          "discounted_cash": 2.08,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2.08
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.62
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2.08
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.02
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.02
            }
          ]
        }
      ]
    },
    {
      "description": "ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION",
      "drug_information": {
        "unit": "10.2",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-130645",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.5,
          "discounted_cash": 0.97,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.15
            }
          ]
        }
      ]
    },
    {
      "description": "ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE",
      "drug_information": {
        "unit": "57",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-130805",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 22.95,
          "discounted_cash": 14.92,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.53
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 14.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.51
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 22.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 17.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.5
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 15.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 18.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 14.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.94
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 14.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.82
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 14.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 14.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.75
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 18.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 16.75
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 18.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 14.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 17.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 20.13
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 20.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 14.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 20.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 19.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 19.03
            }
          ]
        }
      ]
    },
    {
      "description": "PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-131067",
          "type": "CDM"
        },
        {
          "code": "J7999",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 36.1,
          "discounted_cash": 23.46,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 23.47
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 29.2
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.18
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 29.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.93
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.82
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.18
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.04
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.6
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.5
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.18
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.82
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 31.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.69
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 36.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31.66
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 23.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.04
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 36.1,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HYDROMORPHONE 15 MG/30 ML (0.5 MG/ML) IN 0.9 % NACL IV PCA SYRINGE",
      "drug_information": {
        "unit": "30",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-131803",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 111.8,
          "discounted_cash": 72.67,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 72.56
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 73.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.03
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 98.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 83.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 90.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 98.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 92.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 92.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 98.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.78
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 111.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 83.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 62.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.78
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 83.85
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 90.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 62.05
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 72.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 85.42
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 62.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 111.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 72.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 95.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 72.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 92.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 70.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 61.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 81.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 62.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 72.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 30.52
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 72.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 70.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 91.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 71.78
            }
          ]
        }
      ]
    },
    {
      "description": "LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE",
      "drug_information": {
        "unit": "4",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-132015",
          "type": "CDM"
        },
        {
          "code": "J1920",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 75.1,
          "discounted_cash": 48.81,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 65.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.46
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 48.82
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.59,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.59,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.26
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.38
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 49.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.58
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 66.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 60.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.33
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.59,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 56.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.59,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.46
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.84
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 20.5
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 54.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.1,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.59,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 65.86
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 47.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.84,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 62.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 61.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.84
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 75.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 57.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 63.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 48.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 60.76
            }
          ],
          "minimum": 1.59,
          "maximum": 1.84
        }
      ]
    },
    {
      "description": "LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT",
      "drug_information": {
        "unit": "3.75",
        "type": "ME"
      },
      "code_information": [
        {
          "code": "RX-13691",
          "type": "CDM"
        },
        {
          "code": "J1950",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7035.8,
          "discounted_cash": 4573.27,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4516.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5769.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4580.31
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6191.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3869.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3688.12,
              "estimated_amount": 3688.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4536.35,
              "estimated_amount": 4536.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5375.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4516.98
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5980.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4516.98
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5980.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4516.98
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5980.43
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5980.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4516.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4516.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3869.69
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5980.43
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1266.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5276.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4580.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4536.35,
              "estimated_amount": 4536.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5375.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5276.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6170.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5980.43
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4643.63
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5980.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5136.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5832.68
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1920.77
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1540.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4516.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4516.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6170.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5980.43
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5980.43
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1266.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4516.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5375.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4446.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4580.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3869.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5769.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3688.12,
              "estimated_amount": 3688.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5769.36
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4536.35,
              "estimated_amount": 4536.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5832.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5769.36
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4446.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4580.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4536.35,
              "estimated_amount": 4536.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5980.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4516.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4536.35,
              "estimated_amount": 4536.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4536.35,
              "estimated_amount": 4536.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3688.12,
              "estimated_amount": 3688.12
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7035.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4446.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4446.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4446.63
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5769.36
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7035.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3869.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4580.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5691.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4516.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4536.35,
              "estimated_amount": 4536.35
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5136.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3688.12,
              "estimated_amount": 3688.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5832.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5769.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4536.35,
              "estimated_amount": 4536.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4536.35,
              "estimated_amount": 4536.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4536.35,
              "estimated_amount": 4536.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4446.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4536.35,
              "estimated_amount": 4536.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4536.35,
              "estimated_amount": 4536.35
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5980.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3869.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3688.12,
              "estimated_amount": 3688.12
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1621.83,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5980.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5769.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4446.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5136.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4573.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5691.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4536.35,
              "estimated_amount": 4536.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5375.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5136.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5375.35
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1544.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5980.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5769.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5375.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3869.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5136.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3869.69
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7035.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4516.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4446.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5276.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5136.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4536.35,
              "estimated_amount": 4536.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4536.35,
              "estimated_amount": 4536.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5980.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4536.35,
              "estimated_amount": 4536.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4536.35,
              "estimated_amount": 4536.35
            }
          ],
          "minimum": 3688.12,
          "maximum": 4536.35
        }
      ]
    },
    {
      "description": "CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION",
      "drug_information": {
        "unit": "1.25",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-1445",
          "type": "CDM"
        },
        {
          "code": "J0690",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 33.65,
          "discounted_cash": 21.87,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.91
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 27.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.6
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.92,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.92,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.27
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.24
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.27
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.59
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 27.9
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 27.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.59
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 27.22
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 21.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 27.22
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.27
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.51
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 21.87
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.92,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.59
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 21.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 29.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.51
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 29.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 28.6
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 21.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.56
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 18.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.59
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 25.71
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 22.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.92,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 29.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 24.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.92,
              "estimated_amount": 1.92
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 25.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.2,
              "estimated_amount": 2.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 33.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 27.59
            }
          ],
          "minimum": 1.92,
          "maximum": 2.2
        }
      ]
    },
    {
      "description": "DORZOLAMIDE 2 % EYE DROPS",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-14471",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 139.85,
          "discounted_cash": 90.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 106.85
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 91.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 90.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 106.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 118.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 113.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 118.87
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 123.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 122.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 118.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 89.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 102.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 91.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 90.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 90.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 102.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 89.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 104.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 89.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 88.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 89.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 88.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 76.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 76.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 106.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 115.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 106.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 118.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 89.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 88.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 115.94
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 92.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 106.85
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 90.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 89.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 102.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 118.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 88.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 88.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 88.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 76.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 114.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 89.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 106.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 102.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 91.04
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 104.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 122.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 139.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 88.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 104.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 114.68
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 118.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 118.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 76.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 115.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 91.04
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 118.87
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 118.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 76.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 89.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 102.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 118.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 114.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 89.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 89.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 102.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 114.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 90.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 76.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 88.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 114.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 113.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 114.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 118.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 89.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 89.78
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 139.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 91.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 118.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 114.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 114.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 76.92
            }
          ]
        }
      ]
    },
    {
      "description": "METFORMIN 850 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-14719",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.15,
          "discounted_cash": 3.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.52
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.83
            }
          ]
        }
      ]
    },
    {
      "description": "WATER FOR INJECTION, BACTERIOSTATIC INJECTION SOLUTION",
      "drug_information": {
        "unit": "30",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-14979",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 41.7,
          "discounted_cash": 27.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.77
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 11.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 34.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 33.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 27.06
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.19
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 36.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 27.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 34.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 27.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 27.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 41.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 27.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 36.57
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 34.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.86
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 27.52
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 41.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 33.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 34.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 23.14
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 26.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.44
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 27.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 36.57
            }
          ]
        }
      ]
    },
    {
      "description": "DESMOPRESSIN 0.1 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-16052",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.6,
          "discounted_cash": 5.59,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.77
            }
          ]
        }
      ]
    },
    {
      "description": "CEFEPIME 1 GRAM SOLUTION FOR INJECTION",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-16369",
          "type": "CDM"
        },
        {
          "code": "J0692",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 44.65,
          "discounted_cash": 29.02,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.11
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 12.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 37.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.62,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 39.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.67
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.27,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 29.02
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 39.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.62,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.27,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.62,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.11
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.27,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.61
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.62,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.62,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.27,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 36.12
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 29.47
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 39.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.61
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.62,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 37.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.62,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.62,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.62,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 36.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.11
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.22
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.62,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.22
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.62,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.62,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.61
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.62,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 36.61
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.62,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.56
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.62,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 37.01
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 24.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.62,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.95
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 33.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.22
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 28.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.62,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.27,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 44.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 32.59
            }
          ],
          "minimum": 6.27,
          "maximum": 6.62
        }
      ]
    },
    {
      "description": "GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "4",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-165421",
          "type": "CDM"
        },
        {
          "code": "J1602",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9776.5,
          "discounted_cash": 6354.72,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6276.51
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8310.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8104.72
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8310.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1540.5,
              "estimated_amount": 1540.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6276.51
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6178.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5377.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1380.6,
              "estimated_amount": 1380.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8016.73
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6276.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6276.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6364.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6364.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1759.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1540.5,
              "estimated_amount": 1540.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1540.5,
              "estimated_amount": 1540.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7469.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7469.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6276.51
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7136.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1380.6,
              "estimated_amount": 1380.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7136.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1380.6,
              "estimated_amount": 1380.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1380.6,
              "estimated_amount": 1380.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1540.5,
              "estimated_amount": 1540.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6276.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6276.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6178.75
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1363,
              "estimated_amount": 1363
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6178.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8573.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7136.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8310.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6178.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6178.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8310.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7136.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1380.6,
              "estimated_amount": 1380.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8104.72
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5377.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5377.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8016.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8016.73
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8310.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7909.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8104.72
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9776.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7332.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5377.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8016.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7469.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8310.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1540.5,
              "estimated_amount": 1540.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1540.5,
              "estimated_amount": 1540.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1540.5,
              "estimated_amount": 1540.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8310.03
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2668.98
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8310.03
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6276.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1540.5,
              "estimated_amount": 1540.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8016.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7136.85
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 2141.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6276.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6178.75
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8310.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8310.03
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1759.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8016.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6276.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7332.38
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8310.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5377.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7469.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6178.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8310.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7332.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1540.5,
              "estimated_amount": 1540.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1540.5,
              "estimated_amount": 1540.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6276.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8573.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5377.08
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8310.03
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9776.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6364.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6364.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1540.5,
              "estimated_amount": 1540.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1540.5,
              "estimated_amount": 1540.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1540.5,
              "estimated_amount": 1540.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6276.51
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1540.5,
              "estimated_amount": 1540.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1540.5,
              "estimated_amount": 1540.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5377.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8016.73
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 607.16,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7909.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6364.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 578.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9776.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1540.5,
              "estimated_amount": 1540.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7469.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6178.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7136.85
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6354.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7469.25
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6452.49
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8603.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1540.5,
              "estimated_amount": 1540.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8016.73
            }
          ],
          "minimum": 1363,
          "maximum": 1540.5
        }
      ]
    },
    {
      "description": "ZOLEDRONIC ACID 4 MG/100 ML-MANNITOL-0.9 % NACL INTRAVENOUS PIGGYBACK",
      "drug_information": {
        "unit": "100",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-166510",
          "type": "CDM"
        },
        {
          "code": "J3489",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 151.35,
          "discounted_cash": 98.38,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 115.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 97.17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 113.51
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 98.53
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.24
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 97.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.12,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.12,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.76,
              "estimated_amount": 64.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 97.17
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 98.53
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.12,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.12,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 97.17
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 98.53
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 110.49
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 124.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 132.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.96,
              "estimated_amount": 64.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 110.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.96,
              "estimated_amount": 64.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 125.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 110.49
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 98.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.12,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.12,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.12,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 124.11
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 124.11
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 98.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.12,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 125.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 125.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 98.53
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.96,
              "estimated_amount": 64.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 115.63
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.24
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 97.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 97.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 124.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 97.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.65
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 124.11
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 97.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.65
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 41.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 122.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 110.49
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.12,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 124.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 115.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 115.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 113.51
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 110.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.65
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 83.24
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 113.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 97.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.12,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.12,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.96,
              "estimated_amount": 64.96
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 133.19
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.12,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.12,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 132.73
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 99.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 115.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 97.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.65
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 110.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 124.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 124.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 97.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 97.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 64.96,
              "estimated_amount": 64.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.12,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.12,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 115.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 95.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 128.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 122.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.12,
              "estimated_amount": 70.12
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 151.35,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 70.12,
              "estimated_amount": 70.12
            }
          ],
          "minimum": 64.76,
          "maximum": 70.12
        }
      ]
    },
    {
      "description": "COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-166520",
          "type": "CDM"
        },
        {
          "code": "J7195",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7819,
          "discounted_cash": 5082.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5019.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4095,
              "estimated_amount": 4095
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1407.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4095,
              "estimated_amount": 4095
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5973.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4941.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4300.45
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4990,
              "estimated_amount": 4990
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6646.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5707.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5973.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4300.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5090.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5090.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6646.15
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6411.58
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6646.15
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5160.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5019.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5019.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4941.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4300.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4095,
              "estimated_amount": 4095
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1712.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5019.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4941.61
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6411.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4990,
              "estimated_amount": 4990
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4990,
              "estimated_amount": 4990
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4990,
              "estimated_amount": 4990
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1407.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5019.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7819,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4300.45
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6646.15
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6646.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5019.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6646.15
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7819,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6880.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4990,
              "estimated_amount": 4990
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6481.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5707.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4990,
              "estimated_amount": 4990
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4990,
              "estimated_amount": 4990
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5090.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4990,
              "estimated_amount": 4990
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5082.35
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5973.72
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4941.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5707.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5019.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5019.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5019.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4941.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4941.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4990,
              "estimated_amount": 4990
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5864.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4300.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6325.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4990,
              "estimated_amount": 4990
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4990,
              "estimated_amount": 4990
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5864.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4300.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4941.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5019.8
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4990,
              "estimated_amount": 4990
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6646.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6411.58
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7819,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6857.26
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5864.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6411.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5090.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6325.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6857.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4990,
              "estimated_amount": 4990
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4990,
              "estimated_amount": 4990
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5707.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4095,
              "estimated_amount": 4095
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4990,
              "estimated_amount": 4990
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6646.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5019.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6646.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5707.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5019.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5973.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4941.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4990,
              "estimated_amount": 4990
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4990,
              "estimated_amount": 4990
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2134.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6646.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6481.95
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6646.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4095,
              "estimated_amount": 4095
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6481.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6411.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6411.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5973.72
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6646.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4300.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5973.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6646.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5090.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5707.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6411.58
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6646.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1756,
              "estimated_amount": 1756
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6411.58
            }
          ],
          "minimum": 1756,
          "maximum": 4990
        }
      ]
    },
    {
      "description": "FERRIC CITRATE 210 MG IRON TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-170653",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 27,
          "discounted_cash": 17.55,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20.63
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 23.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.96
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 21.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 23.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.06
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 21.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 17.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 17.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20.63
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 17.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 17.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.96
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 20.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 17.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 22.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.96
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 20.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 17.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.33
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 17.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 22.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 17.52
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.33
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 20.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 17.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 17.52
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 27,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 14.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 22.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 17.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 16.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 23.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.14
            }
          ]
        }
      ]
    },
    {
      "description": "VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "0.25",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-171371",
          "type": "CDM"
        },
        {
          "code": "J2598",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 51.25,
          "discounted_cash": 33.31,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 42.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.15,
              "estimated_amount": 26.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.15,
              "estimated_amount": 26.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.56
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 33.31
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.15,
              "estimated_amount": 26.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.56
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 38.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.15,
              "estimated_amount": 26.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.15,
              "estimated_amount": 26.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.15,
              "estimated_amount": 26.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.9
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.25,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.39
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.56
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.56
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 13.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 42.49
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.15,
              "estimated_amount": 26.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.15,
              "estimated_amount": 26.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 41.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.15,
              "estimated_amount": 26.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22,
              "estimated_amount": 22
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.15,
              "estimated_amount": 26.15
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 45.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 38.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22,
              "estimated_amount": 22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.15,
              "estimated_amount": 26.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.15,
              "estimated_amount": 26.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22,
              "estimated_amount": 22
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 33.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 41.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.15,
              "estimated_amount": 26.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.15,
              "estimated_amount": 26.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 37.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22,
              "estimated_amount": 22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 32.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.39
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 33.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.15,
              "estimated_amount": 26.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 42.49
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 51.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.15,
              "estimated_amount": 26.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 39.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 28.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 26.15,
              "estimated_amount": 26.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 22,
              "estimated_amount": 22
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 38.44
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 43.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 32.39
            }
          ],
          "minimum": 22,
          "maximum": 26.15
        }
      ]
    },
    {
      "description": "CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "4.52",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-172920",
          "type": "CDM"
        },
        {
          "code": "J0714",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 724.55,
          "discounted_cash": 470.96,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 465.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 465.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 615.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 446.66,
              "estimated_amount": 446.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 553.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 465.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.08,
              "estimated_amount": 543.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 457.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.08,
              "estimated_amount": 543.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 457.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 446.66,
              "estimated_amount": 446.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.08,
              "estimated_amount": 543.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 615.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 471.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 586.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.08,
              "estimated_amount": 543.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.08,
              "estimated_amount": 543.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 615.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 615.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 528.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 398.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 615.87
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 615.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.08,
              "estimated_amount": 543.08
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 615.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 600.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 465.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 635.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.08,
              "estimated_amount": 543.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.08,
              "estimated_amount": 543.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 594.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.08,
              "estimated_amount": 543.08
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 637.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.08,
              "estimated_amount": 543.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 528.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 594.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 594.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 553.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 465.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 457.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 398.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 446.66,
              "estimated_amount": 446.66
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 615.87
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 615.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 398.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 594.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 528.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 471.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 553.56
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 724.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 398.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 446.66,
              "estimated_amount": 446.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 594.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 553.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 465.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 398.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 553.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 465.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 553.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 457.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 457.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 398.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 528.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 471.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 586.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 615.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 465.16
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 478.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 471.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 635.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 543.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 528.92
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 197.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 543.41
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 615.87
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 470.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.08,
              "estimated_amount": 543.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.08,
              "estimated_amount": 543.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.08,
              "estimated_amount": 543.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 457.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.08,
              "estimated_amount": 543.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 594.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 594.13
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 543.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 465.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 465.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 457.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.08,
              "estimated_amount": 543.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 398.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 600.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 465.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.08,
              "estimated_amount": 543.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 528.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 594.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 471.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 543.08,
              "estimated_amount": 543.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 457.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 600.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 465.16
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 615.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 446.66,
              "estimated_amount": 446.66
            }
          ],
          "minimum": 446.66,
          "maximum": 543.08
        }
      ]
    },
    {
      "description": "TACROLIMUS XR 1 MG TABLET,EXTENDED RELEASE 24 HR",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-174722",
          "type": "CDM"
        },
        {
          "code": "J7503",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 21.6,
          "discounted_cash": 14.04,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.71
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.71
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.87
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 17.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 17.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.87
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 21.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 17.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.36
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 14.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 18.94
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 18.94
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 14.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 17.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.88
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 17.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.36
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 19.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 13.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "CLONIDINE HCL 0.1 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-1755",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.3,
          "discounted_cash": 3.44,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.94
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "AETNA [310]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 2.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.35
            }
          ]
        }
      ]
    },
    {
      "description": "BRIVARACETAM 50 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-178109",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 73.9,
          "discounted_cash": 48.03,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.44
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 40.65
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
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            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 47.96
            },
            {
              "payer_name": "AETNA [310]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 56.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
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              "standard_charge_percentage": 87.7,
              "estimated_amount": 64.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
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              "standard_charge_percentage": 75,
              "estimated_amount": 55.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 40.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 53.95
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 53.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 46.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
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              "standard_charge_percentage": 80.9,
              "estimated_amount": 59.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 46.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 41.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 61.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 46.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 46.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 56.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 46.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 46.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 41.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 46.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 46.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 53.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 53.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 73.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.44
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 48.77
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 20.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 64.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 46.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 40.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 40.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 56.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 46.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 40.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 53.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 46.41
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 53.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 41.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 61.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 47.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 46.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 46.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 46.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 46.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 46.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 56.46
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 55.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 56.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 55.43
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 59.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 46.41
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 65.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 40.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 48.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 46.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 41.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 40.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 48.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.44
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 73.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 61.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 47.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 56.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 47.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 46.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 60.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 46.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 47.96
            }
          ]
        }
      ]
    },
    {
      "description": "BISOPROLOL FUMARATE 5 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-18288",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.5,
          "discounted_cash": 4.87,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.63
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.38
            }
          ]
        }
      ]
    },
    {
      "description": "LIDOCAINE 4 %-RACEPINEPHRINE 0.05 %-TETRACAINE 0.5 % TOPICAL SOLUTION",
      "drug_information": {
        "unit": "3",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-182997",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 39.95,
          "discounted_cash": 25.97,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.96
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 26.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 25.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33.12
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 35.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 35.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.96
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.96
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 25.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.65
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 32.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 25.93
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 39.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 25.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.96
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 10.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 39.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.52
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.96
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 35.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 25.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 32.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33.12
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.16
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.96
            }
          ]
        }
      ]
    },
    {
      "description": "GABAPENTIN 100 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-18309",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.9,
          "discounted_cash": 3.18,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            }
          ]
        }
      ]
    },
    {
      "description": "STERILE TALC 4 GRAM INTRAPLEURAL SUSPENSION",
      "drug_information": {
        "unit": "4",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-184540",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 738.5,
          "discounted_cash": 480.02,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 474.12
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 627.73
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 627.73
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 627.73
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 627.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 627.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 539.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 612.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 466.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 463.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 564.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 564.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 605.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 474.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 564.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 406.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 605.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 463.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 474.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 474.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 474.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 406.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 409.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 612.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 479.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 627.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 627.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 539.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 474.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 627.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 553.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 597.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 480.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 463.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 474.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 605.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 479.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 539.11
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 627.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 466.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 627.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 597.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 406.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 474.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 466.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 480.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 463.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 409.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 647.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 480.76
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 487.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 539.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 605.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 605.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 480.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 463.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 463.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 480.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 463.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 463.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 474.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 564.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 466.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 605.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 409.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 463.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 406.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 605.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 647.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 474.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 466.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 539.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 605.57
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 201.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 406.18
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 627.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 474.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 466.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 463.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 409.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 463.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 564.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 479.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 479.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 463.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 466.73
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 553.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 474.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 553.88
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 738.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 627.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 406.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 564.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 466.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 539.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 738.5
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 649.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 406.18
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 480.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 463.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 612.22
            }
          ]
        }
      ]
    },
    {
      "description": "EPOETIN ALFA-EPBX 40,000 UNIT/ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-185090",
          "type": "CDM"
        },
        {
          "code": "Q5106",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1692.5,
          "discounted_cash": 1100.12,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1293.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 739.2,
              "estimated_amount": 739.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1101.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1438.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1387.85
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 702.94,
              "estimated_amount": 702.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 739.2,
              "estimated_amount": 739.2
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1438.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1235.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1387.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1086.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1101.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 739.2,
              "estimated_amount": 739.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 739.2,
              "estimated_amount": 739.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 739.2,
              "estimated_amount": 739.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 930.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1387.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1438.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1086.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1086.59
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1438.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 739.2,
              "estimated_amount": 739.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 739.2,
              "estimated_amount": 739.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1369.23
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 702.94,
              "estimated_amount": 702.94
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 930.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1235.53
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1692.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 370.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1293.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 930.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 702.94,
              "estimated_amount": 702.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1069.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 739.2,
              "estimated_amount": 739.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 739.2,
              "estimated_amount": 739.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 739.2,
              "estimated_amount": 739.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 702.94,
              "estimated_amount": 702.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1387.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1403.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1101.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1086.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1403.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1086.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1069.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1438.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1293.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1086.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1235.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 702.94,
              "estimated_amount": 702.94
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1438.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 739.2,
              "estimated_amount": 739.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1438.63
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1438.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1086.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1484.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1269.38
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1438.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 739.2,
              "estimated_amount": 739.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 930.88
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 462.05
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1438.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1293.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1269.38
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1438.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 739.2,
              "estimated_amount": 739.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 930.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1387.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1403.08
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1293.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 739.2,
              "estimated_amount": 739.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1235.53
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1489.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1101.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 739.2,
              "estimated_amount": 739.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1692.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1235.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1069.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1069.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1069.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1235.53
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1692.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1692.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1086.59
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1117.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 930.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1369.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1086.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1086.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1086.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1069.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1101.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1293.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1069.66
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1438.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 930.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1387.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1438.63
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1269.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1484.32
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1692.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1086.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1069.66
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 309.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 294.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1438.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 739.2,
              "estimated_amount": 739.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 739.2,
              "estimated_amount": 739.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1100.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1387.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1387.85
            }
          ],
          "minimum": 702.94,
          "maximum": 739.2
        }
      ]
    },
    {
      "description": "PARENTERAL AMINO ACID 15 % COMBINATION NO.5 INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "2000",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-185746",
          "type": "CDM"
        },
        {
          "code": "J3490",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 355.5,
          "discounted_cash": 231.07,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 271.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 195.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 231.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 195.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 259.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 294.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 291.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 291.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 287.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.18
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 231.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.23
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 259.52
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 266.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 224.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.23
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 266.63
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 195.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 291.51
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 195.53
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 234.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 291.51
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 195.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 224.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 291.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 271.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 224.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 224.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 259.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 291.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 291.51
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 224.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.18
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 311.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 287.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 311.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 231.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 271.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 224.68
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 266.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 259.52
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 231.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 224.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 294.71
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 97.05
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 312.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 294.71
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 271.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 195.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 259.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 291.51
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 231.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 271.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.23
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 195.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 259.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.23
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 231.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 271.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 228.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 224.68
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 302.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 355.5,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM ORAL POWDER PACKET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-185748",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 61.6,
          "discounted_cash": 40.04,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 39.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 39.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 39.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.68
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 51.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.68
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.68
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 61.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.97
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 40.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.68
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 16.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 49.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 46.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 50.51
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 40.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 51.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 38.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 34.19
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 54.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 47.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 49.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 39.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 51.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.36
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.36
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 46.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.97
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 40.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 39.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 54.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 61.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.93
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 46.2
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 52.36
            }
          ]
        }
      ]
    },
    {
      "description": "OMALIZUMAB 150 MG/ML SUBCUTANEOUS SYRINGE",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-186625",
          "type": "CDM"
        },
        {
          "code": "J2357",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6943.35,
          "discounted_cash": 4513.18,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5304.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3818.84
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5901.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5756.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5693.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5207.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2584.06,
              "estimated_amount": 2584.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4388.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5901.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4457.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5304.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4457.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5693.55
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1136.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4457.63
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6943.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4457.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2584.06,
              "estimated_amount": 2584.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5693.55
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5207.51
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5901.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3116.1,
              "estimated_amount": 3116.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4388.2
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4582.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3116.1,
              "estimated_amount": 3116.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5901.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3818.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5693.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5304.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5068.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4520.12
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3116.1,
              "estimated_amount": 3116.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3116.1,
              "estimated_amount": 3116.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3818.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4457.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3116.1,
              "estimated_amount": 3116.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5068.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5304.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6089.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5617.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5304.72
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5068.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5693.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4520.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3116.1,
              "estimated_amount": 3116.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3116.1,
              "estimated_amount": 3116.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4388.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4520.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3116.1,
              "estimated_amount": 3116.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3116.1,
              "estimated_amount": 3116.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3818.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2584.06,
              "estimated_amount": 2584.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5693.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3818.84
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3116.1,
              "estimated_amount": 3116.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3116.1,
              "estimated_amount": 3116.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3116.1,
              "estimated_amount": 3116.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5901.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5068.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3116.1,
              "estimated_amount": 3116.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5901.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4388.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3116.1,
              "estimated_amount": 3116.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5068.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5304.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5901.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4457.63
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4513.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5756.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4457.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3116.1,
              "estimated_amount": 3116.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4388.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4520.12
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1249.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1249.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6089.32
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6110.15
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6943.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5068.65
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1520.59
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5901.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4520.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4457.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3116.1,
              "estimated_amount": 3116.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2584.06,
              "estimated_amount": 2584.06
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6943.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4457.63
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1214.7,
              "estimated_amount": 1214.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2584.06,
              "estimated_amount": 2584.06
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5901.85
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3116.1,
              "estimated_amount": 3116.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5901.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1895.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4388.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5901.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5207.51
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5901.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4388.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3818.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3818.84
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1082.1,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4457.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4457.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4457.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5617.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5756.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5693.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5693.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4388.2
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5901.85
            }
          ],
          "minimum": 1214.7,
          "maximum": 3116.1
        }
      ]
    },
    {
      "description": "PARENTERAL AMINO ACID 15 % COMBINATION NO.6 INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "1000",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-187771",
          "type": "CDM"
        },
        {
          "code": "J3490",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 271.45,
          "discounted_cash": 176.44,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 207.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 222.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 222.59
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 176.71
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 176.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 222.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 219.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.27
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 176.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 222.59
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 207.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.56
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 207.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.27
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.3
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 222.59
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 238.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 222.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 225.03
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 207.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 238.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 176.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 176.71
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 225.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.27
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.27
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 207.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 225.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 222.59
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 179.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 171.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.16
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.73
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 198.16
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 176.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 203.59
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 238.88
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.73
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.27
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 74.11
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 149.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 222.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 219.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 203.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 174.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 207.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 203.59
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 230.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 271.45,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "CENOBAMATE 50 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-190565",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 118.4,
          "discounted_cash": 76.96,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 76.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 77.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 74.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 77.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 74.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 97.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 76.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 76.01
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 65.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 98.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 76.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 86.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 97.09
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 65.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 95.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 77.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 74.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 65.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 97.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 90.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 74.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 86.43
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 32.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 90.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 90.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 76.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.83
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 88.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 65.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 76.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 97.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 97.09
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 76.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 77.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 65.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 98.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 86.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 65.71
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 90.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 74.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 65.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 86.43
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 78.14
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 104.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 74.36
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 97.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 77.08
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 76.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 74.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 76.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 90.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 65.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 95.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 74.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 76.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 88.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 65.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 86.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 118.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 76.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.64
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 88.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 76.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 76.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 76.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 74.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 97.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 98.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 76.84
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 118.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 74.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 86.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 97.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 103.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 65.71
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 76.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 103.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 74.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 74.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 76.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 90.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 74.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 100.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 65.71
            }
          ]
        }
      ]
    },
    {
      "description": "EPTINEZUMAB-JJMR 100 MG/ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-190589",
          "type": "CDM"
        },
        {
          "code": "J3032",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9153.1,
          "discounted_cash": 5949.51,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5876.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5784.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4223.7,
              "estimated_amount": 4223.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7587.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5876.29
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7780.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5876.29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7780.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7404.86
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6681.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7505.54
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8054.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5057,
              "estimated_amount": 5057
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5784.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5034.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5034.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6681.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6681.76
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9153.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5057,
              "estimated_amount": 5057
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5876.29
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7780.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6681.76
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7780.14
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5057,
              "estimated_amount": 5057
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2498.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4223.7,
              "estimated_amount": 4223.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5034.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5876.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5958.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5057,
              "estimated_amount": 5057
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7505.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5057,
              "estimated_amount": 5057
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5876.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5784.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5958.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5057,
              "estimated_amount": 5057
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5057,
              "estimated_amount": 5057
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7780.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5034.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7505.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5057,
              "estimated_amount": 5057
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5949.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5876.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6992.97
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7780.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4223.7,
              "estimated_amount": 4223.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7505.54
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9153.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7780.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5958.67
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1647.56
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1647.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5876.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6992.97
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7780.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7780.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7505.54
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6864.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5034.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6992.97
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5784.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5057,
              "estimated_amount": 5057
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7780.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7780.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9153.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4223.7,
              "estimated_amount": 4223.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5876.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5057,
              "estimated_amount": 5057
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5057,
              "estimated_amount": 5057
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5784.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5057,
              "estimated_amount": 5057
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5784.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6864.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5034.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7780.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6681.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7587.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5057,
              "estimated_amount": 5057
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4223.7,
              "estimated_amount": 4223.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7505.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7404.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5057,
              "estimated_amount": 5057
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5876.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5876.29
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1857.14,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6992.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6992.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7587.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6992.97
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 2004.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5034.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5876.29
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6864.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6681.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5057,
              "estimated_amount": 5057
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5057,
              "estimated_amount": 5057
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7780.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7780.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8027.27
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5958.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5958.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5784.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5784.76
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6041.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7505.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8027.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5057,
              "estimated_amount": 5057
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1768.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7505.54
            }
          ],
          "minimum": 4223.7,
          "maximum": 5057
        }
      ]
    },
    {
      "description": "CABERGOLINE 0.5 MG TABLET",
      "drug_information": {
        "unit": "2",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-19226",
          "type": "CDM"
        },
        {
          "code": "J8515",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 16.35,
          "discounted_cash": 10.63,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 16.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 10.79
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.9
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.99
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.9
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 14.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.99
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16.35,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.99
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10.33
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14.34
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 10.63
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.9
            }
          ]
        }
      ]
    },
    {
      "description": "CEFAZOLIN 2 GRAM SOLUTION FOR INJECTION",
      "drug_information": {
        "unit": "2000",
        "type": "ME"
      },
      "code_information": [
        {
          "code": "RX-196910",
          "type": "CDM"
        },
        {
          "code": "63600006",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 53.8,
          "discounted_cash": 34.97,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.54
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.73
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.12
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 35.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.6
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 43.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.54
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.27
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 47.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.12
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 40.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 43.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 44.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 47.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.54
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.54
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 14.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 39.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 44.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.73
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 34.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 47.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 45.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 41.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 34.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 53.8,
              "additional_payer_notes": "SRD"
            }
          ]
        }
      ]
    },
    {
      "description": "PRAMOXINE 1 % TOPICAL FOAM",
      "drug_information": {
        "unit": "15",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-19749",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 363.15,
          "discounted_cash": 236.05,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 233.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 229.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 236.41
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 308.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 199.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 265.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 297.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 233.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 272.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 228.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 235.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 265.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 201.55
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 319.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 277.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 277.45
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 99.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 199.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 199.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 301.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 228.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 235.68
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 308.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 308.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 199.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 228.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 233.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 318.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 229.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 293.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 233.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 308.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 272.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 265.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 236.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 199.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 199.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 308.68
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 363.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 301.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 236.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 235.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 277.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 236.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 277.45
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 308.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 297.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 233.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 293.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 265.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 308.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 233.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 229.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 228.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 308.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 229.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 277.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 229.51
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 239.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 363.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 201.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 228.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 228.06
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 272.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 297.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 233.14
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 308.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 236.41
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 308.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 235.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 265.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 233.14
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 308.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 318.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 233.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 233.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 265.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 228.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 228.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 297.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 233.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 277.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 201.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 308.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 228.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 228.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 297.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 297.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 297.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 229.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 301.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 199.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 228.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 233.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 229.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 236.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 297.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 229.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 201.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 228.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 228.06
            }
          ]
        }
      ]
    },
    {
      "description": "MEROPENEM 2 GRAM INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "500",
        "type": "ME"
      },
      "code_information": [
        {
          "code": "RX-202948",
          "type": "CDM"
        },
        {
          "code": "J2183",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 69.2,
          "discounted_cash": 44.98,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 69.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 55.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 51.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 57.37
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.95,
              "estimated_amount": 21.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.95,
              "estimated_amount": 21.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.95,
              "estimated_amount": 21.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.95,
              "estimated_amount": 21.95
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 69.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 69.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.73
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 69.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.95,
              "estimated_amount": 21.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 57.37
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 18.89
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 69.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.95,
              "estimated_amount": 21.95
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 51.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.95,
              "estimated_amount": 21.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.95,
              "estimated_amount": 21.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 51.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 45.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.95,
              "estimated_amount": 21.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.95,
              "estimated_amount": 21.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.95,
              "estimated_amount": 21.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 55.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.95,
              "estimated_amount": 21.95
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 60.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.95,
              "estimated_amount": 21.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.95,
              "estimated_amount": 21.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 69.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 38.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.95,
              "estimated_amount": 21.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 60.69
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 44.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 60.69
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 57.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.95,
              "estimated_amount": 21.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 21.95,
              "estimated_amount": 21.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.74
            }
          ],
          "minimum": 21.95,
          "maximum": 21.95
        }
      ]
    },
    {
      "description": "KETAMINE (PF) 5 MG/ML IN SODIUM CHLORIDE, ISO-OSMOTIC IV SOLUTION",
      "drug_information": {
        "unit": "100",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-204538",
          "type": "CDM"
        },
        {
          "code": "J7999",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 792.95,
          "discounted_cash": 515.42,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.07
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.01
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 650.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 440.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 516.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 650.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 650.22
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 594.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 516.21
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.12
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 605.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 695.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.12
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 697.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 594.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 440.09
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.01
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 657.36
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 440.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 650.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 650.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.14
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.01
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 605.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 605.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 641.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 594.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.14
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 578.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 440.09
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 515.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 605.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.01
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 605.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 578.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 516.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 516.21
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 792.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 578.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.01
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 216.48
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 578.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 578.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 695.42
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 523.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 578.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 657.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 650.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.07
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 650.22
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.01
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 792.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 674.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 605.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 509.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 516.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 657.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 501.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 650.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 641.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 436.12
            }
          ]
        }
      ]
    },
    {
      "description": "FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE",
      "drug_information": {
        "unit": ".5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-204981",
          "type": "CDM"
        },
        {
          "code": "90656",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 137.15,
          "discounted_cash": 89.15,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.02,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.05
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 137.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.57,
              "estimated_amount": 60.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 120.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.46
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.57,
              "estimated_amount": 60.57
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 102.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 89.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.57,
              "estimated_amount": 60.57
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.12
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.57,
              "estimated_amount": 60.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.02,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.57,
              "estimated_amount": 60.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.57,
              "estimated_amount": 60.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.02,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 89.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.46
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 120.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.57,
              "estimated_amount": 60.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.57,
              "estimated_amount": 60.57
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 137.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.02,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 137.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 37.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.57,
              "estimated_amount": 60.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 102.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 102.86
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.57,
              "estimated_amount": 60.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 110.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.68
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 90.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 110.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.57,
              "estimated_amount": 60.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 113.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 120.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 86.68
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 89.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.57,
              "estimated_amount": 60.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.57,
              "estimated_amount": 60.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 75.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.02,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 113.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 137.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.57,
              "estimated_amount": 60.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 100.12
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 137.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.05
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.57,
              "estimated_amount": 60.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 113.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 89.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.57,
              "estimated_amount": 60.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 60.57,
              "estimated_amount": 60.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 112.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 89.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 116.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 104.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 89.28
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 137.15,
              "additional_payer_notes": "ALL OTHER OP"
            }
          ],
          "minimum": 0.02,
          "maximum": 60.57
        }
      ]
    },
    {
      "description": "AZITHROMYCIN 250 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-20943",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.35,
          "discounted_cash": 4.13,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.35
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.64
            }
          ]
        }
      ]
    },
    {
      "description": "DAPSONE 25 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-2132",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.45,
          "discounted_cash": 4.84,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.78
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.11
            }
          ]
        }
      ]
    },
    {
      "description": "LETROZOLE 2.5 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-21509",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.75,
          "discounted_cash": 3.74,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.89
            }
          ]
        }
      ]
    },
    {
      "description": "MUPIROCIN CALCIUM 2 % TOPICAL CREAM",
      "drug_information": {
        "unit": "15",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-22251",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 298.15,
          "discounted_cash": 193.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 163.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 193.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 188.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 223.61
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 227.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 194.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.24
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 298.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 217.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 227.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 188.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 194.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 193.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 244.48
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 193.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 163.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 244.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 227.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 188.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 217.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 247.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 165.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 247.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 194.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 188.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 261.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 217.65
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 81.39
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 262.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 163.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 163.98
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 227.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 244.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 241.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 217.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 165.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 244.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 227.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 223.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 165.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 241.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 188.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 261.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 194.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 163.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 217.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 244.48
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 188.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 298.15
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 244.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 244.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 194.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 187.24
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 193.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.41
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 188.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 193.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 165.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 163.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 163.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 244.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 253.43
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 223.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 217.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 191.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 227.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 188.43
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 196.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 247.17
            }
          ]
        }
      ]
    },
    {
      "description": "MONTELUKAST 10 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-22509",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.6,
          "discounted_cash": 3.64,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
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              "standard_charge_percentage": 66,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.6,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION",
      "drug_information": {
        "unit": "3",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-250",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.25,
          "discounted_cash": 3.41,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.01
            }
          ]
        }
      ]
    },
    {
      "description": "CEFAZOLIN 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK",
      "drug_information": {
        "unit": "50",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-25365",
          "type": "CDM"
        },
        {
          "code": "J0690",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 91.05,
          "discounted_cash": 59.18,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.45
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 80.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 75.48
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.45
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 68.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.4,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.84,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.66
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 68.29
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.4,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.4,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.54
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 68.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.4,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.66
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.54
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.4,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.4,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.4,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.4,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.47
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.4,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.4,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.39
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 79.85
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 75.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.56
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 75.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.66
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 24.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 79.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.66
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.39
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.66
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 57.54
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 60.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.84,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.4,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.4,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.4,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.84,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.66
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.56
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.84,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 59.27
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.45
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.4,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 50.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 74.66
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 73.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.4,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.4,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 91.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 66.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 58.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 69.56
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 73.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.84,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.4,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 59.18
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 77.39
            }
          ],
          "minimum": 3.84,
          "maximum": 4.4
        }
      ]
    },
    {
      "description": "OXCARBAZEPINE 150 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-27049",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.85,
          "discounted_cash": 3.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.85
            }
          ]
        }
      ]
    },
    {
      "description": "CLONIDINE (PF) 5,000 MCG/10 ML EPIDURAL SOLUTION",
      "drug_information": {
        "unit": "0.3",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-27113",
          "type": "CDM"
        },
        {
          "code": "J0735",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 19.6,
          "discounted_cash": 12.74,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.83,
              "estimated_amount": 19.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 14.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 15.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.39
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 12.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.58
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.83,
              "estimated_amount": 19.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 14.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16.25
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 12.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 14.97
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.07
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.83,
              "estimated_amount": 19.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 15.86
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.58
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.07
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 17.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 14.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.07
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.83,
              "estimated_amount": 19.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.83,
              "estimated_amount": 19.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.58
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 14.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.39
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14.7
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.78
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 17.19
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.58
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 14.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.07
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 17.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 49.78,
              "estimated_amount": 49.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 19.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.31
            }
          ],
          "minimum": 39.83,
          "maximum": 49.78
        }
      ]
    },
    {
      "description": "NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-27181",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8,
          "discounted_cash": 5.2,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.28
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.44
            }
          ]
        }
      ]
    },
    {
      "description": "CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-27507",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 94.25,
          "discounted_cash": 61.26,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 52.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.19
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 70.69
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.84
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 78.13
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 82.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 76.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 70.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 52.31
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 25.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 76.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 61.17
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 70.69
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61.36
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 62.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.19
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.11
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 61.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.51
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.57
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 61.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 82.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 78.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 52.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 72.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 61.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 72.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 82.66
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 78.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 72.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 72.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 61.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 94.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 72.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 80.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 68.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 72.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 59.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 61.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 52.31
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 94.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 51.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 59.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 77.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 60.51
            }
          ]
        }
      ]
    },
    {
      "description": "ONDANSETRON 8 MG DISINTEGRATING TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-27698",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.7,
          "discounted_cash": 3.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.61
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.56
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.67
            }
          ]
        }
      ]
    },
    {
      "description": "PERITON.DIALYSIS SOLN 6-1.5 % DEXTROS LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L",
      "drug_information": {
        "unit": "2000",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-27796",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 97.85,
          "discounted_cash": 63.6,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 86.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.82
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 61.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 61.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 71.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 54.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 74.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.17
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 71.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 71.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.17
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 73.39
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 64.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 61.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 63.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 71.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 63.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 63.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 54.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 97.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 73.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 54.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 85.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 63.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 79.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 71.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 74.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 54.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 81.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 63.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 85.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 61.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 80.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 79.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 74.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 61.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 61.84
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.17
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 63.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 53.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 71.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 63.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 63.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 74.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.17
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 97.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 81.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 74.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 74.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 61.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 61.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 63.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 83.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 61.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 81.12
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 26.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 63.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 62.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 73.39
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 109.05,
          "discounted_cash": 70.88,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.31
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 29.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 60.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 79.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 70.99
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 81.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 70.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 95.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 79.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 60.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 70.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 70.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 90.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.42
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 109.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 70.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 79.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 70.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 88.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 109.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 79.61
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 81.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 70.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.42
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 70.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 60.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 79.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 95.64
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 95.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 70.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 71.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 88.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 70.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 68.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 83.31
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 60.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 59.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 90.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 90.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 92.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 89.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 70.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 81.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 79.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 68.48
            }
          ]
        }
      ]
    },
    {
      "description": "CITALOPRAM 10 MG/5 ML ORAL SOLUTION",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-28228",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 13.45,
          "discounted_cash": 8.74,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 11.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.15
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 11.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 8.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 13.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 8.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 11.8
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.82
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.67
            }
          ]
        }
      ]
    },
    {
      "description": "ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-2900",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 43.1,
          "discounted_cash": 28.01,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.67
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 28.45
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 28.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.07
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.34
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 37.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 34.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 27.97
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.34
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 11.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 27.97
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 35.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 35.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 23.92
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.24
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 27.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 27.97
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 35.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 43.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 34.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 37.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.07
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 23.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.67
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 32.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 23.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 27.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.67
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.33
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 23.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.33
            }
          ]
        }
      ]
    },
    {
      "description": "BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-29396",
          "type": "CDM"
        },
        {
          "code": "J0583",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 304.8,
          "discounted_cash": 198.12,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 195.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 195.68
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 222.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 115,
              "estimated_amount": 115
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 115,
              "estimated_amount": 115
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 249.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 249.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 228.6
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 232.87
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 249.94
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 246.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 115,
              "estimated_amount": 115
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 115,
              "estimated_amount": 115
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 232.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 249.94
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 115,
              "estimated_amount": 115
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 249.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 192.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 195.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 195.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 115,
              "estimated_amount": 115
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 232.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 192.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 267.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 246.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 252.68
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 249.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 192.63
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 201.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 192.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 115,
              "estimated_amount": 115
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 146.25,
              "estimated_amount": 146.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 167.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 146.25,
              "estimated_amount": 146.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 249.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 167.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 222.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 222.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 195.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 195.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 192.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 198.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 115,
              "estimated_amount": 115
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 83.21
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 195.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 195.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 192.63
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 222.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 222.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 198.42
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 267.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 115,
              "estimated_amount": 115
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 232.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 115,
              "estimated_amount": 115
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 228.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 167.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 198.42
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 146.25,
              "estimated_amount": 146.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 115,
              "estimated_amount": 115
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 115,
              "estimated_amount": 115
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 222.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 195.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 195.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 167.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 192.63
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 198.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 249.94
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 195.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 146.25,
              "estimated_amount": 146.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 167.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 198.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 115,
              "estimated_amount": 115
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 115,
              "estimated_amount": 115
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 252.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 232.87
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 167.64
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 228.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 198.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 115,
              "estimated_amount": 115
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 195.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 232.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 259.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 192.63
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 304.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 268.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 167.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 115,
              "estimated_amount": 115
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 252.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 115,
              "estimated_amount": 115
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 146.25,
              "estimated_amount": 146.25
            }
          ],
          "minimum": 115,
          "maximum": 146.25
        }
      ]
    },
    {
      "description": "FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "0.5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-3037",
          "type": "CDM"
        },
        {
          "code": "J3010",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 34.9,
          "discounted_cash": 22.68,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 23.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.44,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.32,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.44,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.44,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.67
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.44,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.44,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.32,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.44,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.44,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.32,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.06
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 22.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.62
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.06
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.44,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.44,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.32,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.18
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.72
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 28.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.44,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.44,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.18
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.72
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.44,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.44,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.44,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.67
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.44,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.66
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.23
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.66
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.67
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.44,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.67
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.61
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.44,
              "estimated_amount": 2.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.32,
              "estimated_amount": 2.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.62
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.18
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 34.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.72
            }
          ],
          "minimum": 2.32,
          "maximum": 2.44
        }
      ]
    },
    {
      "description": "FERROUS GLUCONATE 324 MG (38 MG IRON) TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-3066",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.9,
          "discounted_cash": 3.18,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.06
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.06
            }
          ]
        }
      ]
    },
    {
      "description": "ALPRAZOLAM 0.25 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-324",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9,
          "discounted_cash": 5.85,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.88
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
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              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.65
            }
          ]
        }
      ]
    },
    {
      "description": "DEXTROAMPHETAMINE SULFATE ER 5 MG CAPSULE,EXTENDED RELEASE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-32415",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 13.75,
          "discounted_cash": 8.94,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 11.28
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.95
            },
            {
              "payer_name": "GREATWEST [550]",
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              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 11.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.51
            },
            {
              "payer_name": "AHPO [305]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 11.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 7.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.51
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 9.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 11.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 7.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 7.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.04
            },
            {
              "payer_name": "OSU [553]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 12.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 12.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.95
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.69
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.69
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 8.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10.04
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 12.1
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 13.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.28
            }
          ]
        }
      ]
    },
    {
      "description": "DEXTROAMPHETAMINE SULFATE ER 10 MG CAPSULE,EXTENDED RELEASE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-32416",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 20.1,
          "discounted_cash": 13.06,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 20.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 13.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.09
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 16.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 13.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 13.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 13.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 13.27
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.36
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 17.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.09
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 13.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.48
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 16.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 17.63
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 20.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.48
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 17.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.48
            }
          ]
        }
      ]
    },
    {
      "description": "MIDODRINE 10 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-33083",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.45,
          "discounted_cash": 4.19,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.29
            }
          ]
        }
      ]
    },
    {
      "description": "ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION",
      "drug_information": {
        "unit": "10",
        "type": "ME"
      },
      "code_information": [
        {
          "code": "RX-33175",
          "type": "CDM"
        },
        {
          "code": "J3486",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 65.45,
          "discounted_cash": 42.54,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.67
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.14,
              "estimated_amount": 20.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.14,
              "estimated_amount": 20.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 49.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.78
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 42.54
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.14,
              "estimated_amount": 20.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.14,
              "estimated_amount": 20.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.14,
              "estimated_amount": 20.14
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.78
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.14,
              "estimated_amount": 20.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.91,
              "estimated_amount": 23.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.61
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.91,
              "estimated_amount": 23.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.91,
              "estimated_amount": 23.91
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 43.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.14,
              "estimated_amount": 20.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 57.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.14,
              "estimated_amount": 20.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.91,
              "estimated_amount": 23.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.67
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.61
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 57.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.36
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 49.09
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.14,
              "estimated_amount": 20.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.14,
              "estimated_amount": 20.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 52.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 54.26
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.36
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.14,
              "estimated_amount": 20.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.14,
              "estimated_amount": 20.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.14,
              "estimated_amount": 20.14
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 54.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 49.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 52.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.61
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 54.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.61
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.14,
              "estimated_amount": 20.14
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.67
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.14,
              "estimated_amount": 20.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.61
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 57.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.14,
              "estimated_amount": 20.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.63
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20.14,
              "estimated_amount": 20.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.91,
              "estimated_amount": 23.91
            }
          ],
          "minimum": 20.14,
          "maximum": 23.91
        }
      ]
    },
    {
      "description": "BUPRENORPHINE HCL 2 MG SUBLINGUAL TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-34711",
          "type": "CDM"
        },
        {
          "code": "J0571",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 13.5,
          "discounted_cash": 8.77,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.48
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 13.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 8.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 11.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 8.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9.86
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.48
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.07
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 11.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.48
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 11.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.19
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 13.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.31
            }
          ]
        }
      ]
    },
    {
      "description": "GUAIFENESIN 100 MG/5 ML ORAL LIQUID",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-3542",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.5,
          "discounted_cash": 0.97,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.94
            }
          ]
        }
      ]
    },
    {
      "description": "VITAMIN B COMPLEX AND VITAMIN C NO.20-FOLIC ACID 1 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-38978",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.15,
          "discounted_cash": 0.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.15
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.08
            }
          ]
        }
      ]
    },
    {
      "description": "TOBRAMYCIN 40 MG/ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "2",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-39918",
          "type": "CDM"
        },
        {
          "code": "J3260",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 39.45,
          "discounted_cash": 25.64,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.93
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.93
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.93
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.93
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 26.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.97,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 34.72
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.97,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 24.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.97,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 31.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 29.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 34.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 10.77
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 25.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 21.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.35
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.97,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 31.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 28.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 32.7
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 34.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 32.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.97,
              "estimated_amount": 5.97
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 25.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 6.15,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 39.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 25.33
            }
          ],
          "minimum": 5.97,
          "maximum": 6.15
        }
      ]
    },
    {
      "description": "DEXTROSE 5 % IV BOLUS",
      "drug_information": {
        "unit": "250",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-400293",
          "type": "CDM"
        },
        {
          "code": "J7060",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 40.5,
          "discounted_cash": 26.32,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.21
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.48
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 32.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.21
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.94
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.48
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 35.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.94
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 2.38,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 35.64
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 26.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.94
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33.57
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 26.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 33.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 40.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 30.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 35.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.6
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 25.6
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 30.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 32.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 34.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 40.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 29.57
            }
          ],
          "minimum": 2.38,
          "maximum": 2.38
        }
      ]
    },
    {
      "description": "ISONIAZID 300 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-4027",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.7,
          "discounted_cash": 4.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.23
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.21
            }
          ]
        }
      ]
    },
    {
      "description": "ISOSORBIDE DINITRATE 5 MG TABLET",
      "drug_information": {
        "unit": "2",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-4068",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7.65,
          "discounted_cash": 4.97,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.84
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.27
            }
          ]
        }
      ]
    },
    {
      "description": "NITROGLYCERIN 100 MCG/ML 10ML SYRINGE (CMP PMX)",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441075",
          "type": "CDM"
        },
        {
          "code": "J2305",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 35.95,
          "discounted_cash": 23.37,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.63,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.63,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.63,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.63,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.63,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.56
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.63,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.56
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 31.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 29.08
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.72
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.95,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.56
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.81
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 23.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.63,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.37,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 29.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.63,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.37,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.63,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.63,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.24
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.56
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.48
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.72
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.56
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.63,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.37,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.63,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.63,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.37,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.48
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 23.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.47
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.63,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.56
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.37,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.63,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.63,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.48
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.95,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 3.63,
              "estimated_amount": 3.63
            }
          ],
          "minimum": 3.37,
          "maximum": 3.63
        }
      ]
    },
    {
      "description": "ALTEPLASE BOLUS AND INFUSION",
      "drug_information": {
        "unit": "100",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441157",
          "type": "CDM"
        },
        {
          "code": "J2997",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 35757.2,
          "discounted_cash": 23242.18,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27318.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19666.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28927.57
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26102.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31359.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 9139.78,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22598.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22598.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20783.88,
              "estimated_amount": 20783.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20783.88,
              "estimated_amount": 20783.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20783.88,
              "estimated_amount": 20783.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22598.55
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 23599.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26102.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22598.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26817.9
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9761.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29320.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29320.9
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 7830.83
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 31466.34
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22598.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29320.9
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23277.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29320.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19666.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26102.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27318.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26817.9
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23277.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26817.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19666.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29642.72
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22598.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29320.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29320.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29320.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35757.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27318.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20783.88,
              "estimated_amount": 20783.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19666.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23277.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22598.55
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 6436.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29320.9
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 6436.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19666.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26102.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 20783.88,
              "estimated_amount": 20783.88
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27318.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35757.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23277.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19666.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27318.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28927.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29642.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19666.46
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35757.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 23242.18
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30393.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 24753,
              "estimated_amount": 24753
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22598.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8704.56,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27318.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23277.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26102.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 26102.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29642.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22956.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31359.06
            }
          ],
          "minimum": 20783.88,
          "maximum": 24753
        }
      ]
    },
    {
      "description": "MIDAZOLAM 50 MG IN NS 100 ML INFUSION (CMP PMX)",
      "drug_information": {
        "unit": "100",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441412",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 72.25,
          "discounted_cash": 46.96,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 40.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.41
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 58.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 47.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 46.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 72.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 40.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 59.9
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 19.72
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 63.58
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.41
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 46.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 72.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 47.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.38
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 47.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 58.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 46.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 40.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 63.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 52.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 59.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 39.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.66
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 59.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 46.89
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.41
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 61.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 59.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
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              "standard_charge_percentage": 87.7,
              "estimated_amount": 63.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 39.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 39.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 47.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 61.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
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              "standard_charge_percentage": 75,
              "estimated_amount": 54.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.66
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 52.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.38
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.66
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 47.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 46.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 59.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.38
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 47.03
            },
            {
              "payer_name": "ANTHEM [335]",
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              "standard_charge_percentage": 55.5,
              "estimated_amount": 40.1
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              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 52.74
            },
            {
              "payer_name": "UHC [625]",
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              "estimated_amount": 45.37
            },
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              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 46.38
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 45.37
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 55.2
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 45.66
            },
            {
              "payer_name": "OSU [553]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 52.74
            }
          ]
        }
      ]
    },
    {
      "description": "LIDOCAINE 2%, BUPIV 0.375%, EPI 1:400,000, HYALURONIDASE 3 UNITS/ML OPH INJ (OUTSOURCED)",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441684",
          "type": "CDM"
        },
        {
          "code": "25000049",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
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          "discounted_cash": 96.3,
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              "payer_name": "AETNA [310]",
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              "estimated_amount": 95.11
            },
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              "estimated_amount": 95.11
            },
            {
              "payer_name": "COVENTRY [406]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 125.93
            },
            {
              "payer_name": "FIRST HEALTH [408]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 125.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 81.48
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 121.48
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 87.7,
              "estimated_amount": 129.93
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 96.15
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 93.04
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            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 113.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
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              "standard_charge_percentage": 75,
              "estimated_amount": 111.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 82.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 81.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
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              "standard_charge_percentage": 55.5,
              "estimated_amount": 82.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.93
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.93
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 130.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 93.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.11
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 93.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 113.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.48
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 96.3
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 40.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 96.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 119.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 122.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.11
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 97.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 93.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 82.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 93.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.11
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 113.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 96.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 93.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 93.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 113.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 96.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 121.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 81.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 93.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 119.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 82.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 93.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 93.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 129.93
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.93
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 111.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 93.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 113.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 96.45
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 148.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 95.11
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 111.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 122.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 148.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 113.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 93.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 93.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.15
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 125.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 108.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 93.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 122.82
            }
          ]
        }
      ]
    },
    {
      "description": "SODIUM CHLORIDE 0.9 % INTRAVENOUS FLUSH (BAG SIZE 100 ML OR LESS)",
      "drug_information": {
        "unit": "100",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-441848",
          "type": "CDM"
        },
        {
          "code": "J7050",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 65.05,
          "discounted_cash": 42.28,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.76
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 57.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.29
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 0.61,
              "estimated_amount": 0.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.35
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.29
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 42.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 36.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.35
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.78
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.49
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.7
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.7
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.78
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 42.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 36.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.11
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 52.63
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 36.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 57.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.49
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 57.05
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 52.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.79
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.29
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 36.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.11
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 65.05
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 65.05,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 0.61,
          "maximum": 0.61
        }
      ]
    },
    {
      "description": "MORPHINE 10 MG/ML INJECTION SOLUTION SORD",
      "drug_information": {
        "unit": "0.5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-461024",
          "type": "CDM"
        },
        {
          "code": "J2272",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 37.8,
          "discounted_cash": 24.57,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.74,
              "estimated_amount": 13.74
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 33.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 33.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.27
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.89
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.74,
              "estimated_amount": 13.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.74,
              "estimated_amount": 13.74
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.74,
              "estimated_amount": 13.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.13
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 10.32
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.74,
              "estimated_amount": 13.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.04,
              "estimated_amount": 17.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.27
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.74,
              "estimated_amount": 13.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.74,
              "estimated_amount": 13.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.74,
              "estimated_amount": 13.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.74,
              "estimated_amount": 13.74
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.74,
              "estimated_amount": 13.74
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.13
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.74,
              "estimated_amount": 13.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.74,
              "estimated_amount": 13.74
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 24.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 24.57
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.04,
              "estimated_amount": 17.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.74,
              "estimated_amount": 13.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.89
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.8,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.04,
              "estimated_amount": 17.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.04,
              "estimated_amount": 17.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.74,
              "estimated_amount": 13.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.74,
              "estimated_amount": 13.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.79
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 32.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.04,
              "estimated_amount": 17.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.74,
              "estimated_amount": 13.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 13.74,
              "estimated_amount": 13.74
            }
          ],
          "minimum": 13.74,
          "maximum": 17.04
        }
      ]
    },
    {
      "description": "MEPERIDINE (PF) 50 MG/ML INJECTION SORD",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-461025",
          "type": "CDM"
        },
        {
          "code": "J2175",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 43.4,
          "discounted_cash": 28.21,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 35.98
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.87
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 35.11
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 28.64
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.59
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.59
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 38.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.15,
              "estimated_amount": 16.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.15,
              "estimated_amount": 16.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.16
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 28.21
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.15,
              "estimated_amount": 16.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.68
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 11.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.43
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.15,
              "estimated_amount": 16.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.59
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 38.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.43
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 35.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 35.98
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 17.67,
              "estimated_amount": 17.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 35.98
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 38.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 36.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.86
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 16.15,
              "estimated_amount": 16.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.59
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.4,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 16.15,
          "maximum": 17.67
        }
      ]
    },
    {
      "description": "POTASSIUM CHLORIDE ER 20 MEQ TABLET SORD",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-461027",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.6,
          "discounted_cash": 3.64,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.64
            }
          ]
        }
      ]
    },
    {
      "description": "NIFEDIPINE ER 60 MG TABLET, EXT RELEASE ORAL SOLID SORD",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-461037",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.6,
          "discounted_cash": 5.59,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.31
            }
          ]
        }
      ]
    },
    {
      "description": "PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % NACL IV SYRINGE SORD",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-461050",
          "type": "CDM"
        },
        {
          "code": "J2370",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 35.45,
          "discounted_cash": 23.04,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 23.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 23.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.59
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.4
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.4
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.67
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 31.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.4
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.39
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 19.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 35.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 27.08
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 29.07
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 31.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 30.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 23.08
            }
          ]
        }
      ]
    },
    {
      "description": "MORPHINE 30 MG/30 ML INTRAVENOUS PCA SYRINGE (NSORD)",
      "drug_information": {
        "unit": "30",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-461077",
          "type": "CDM"
        },
        {
          "code": "J2270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 377.65,
          "discounted_cash": 245.47,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 242.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 321
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 321
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.31,
              "estimated_amount": 31.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.36,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 242.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 288.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 242.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 245.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.36,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 207.71
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 321
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 207.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 238.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 242.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 238.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.36,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 321
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.36,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 242.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 242.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 331.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.31,
              "estimated_amount": 31.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 275.68
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 245.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 207.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.36,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 321
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 321
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 275.68
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 245.47
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 242.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 242.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 242.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 238.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 238.67
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 313.07
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 242.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.36,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.36,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 309.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 245.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 288.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.31,
              "estimated_amount": 31.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 321
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 321
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 238.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 245.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 309.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 305.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 321
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 207.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.31,
              "estimated_amount": 31.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.36,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.36,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.36,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 313.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 242.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 238.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 321
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 249.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.36,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 207.71
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 283.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 275.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 321
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 238.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 245.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.36,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 207.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 275.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 275.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 309.67
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 242.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 321
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 305.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 275.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 31.31,
              "estimated_amount": 31.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 309.67
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 321
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.36,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 288.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 288.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 309.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 103.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 283.24
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 332.33
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 283.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 321
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 313.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.36,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 288.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 207.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 309.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 331.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 309.67
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.36,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 309.67
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.36,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 39.36,
              "estimated_amount": 39.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 288.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 238.67
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 377.65,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 31.31,
          "maximum": 39.36
        }
      ]
    },
    {
      "description": "MAGNESIUM CITRATE ORAL SOLUTION",
      "drug_information": {
        "unit": "296",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-4712",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 19.8,
          "discounted_cash": 12.87,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.83
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 16.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.13
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.24
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 12.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.43
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 13.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14.85
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 17.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 19.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.89
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.83
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 19.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 16.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.24
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 17.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 17.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.43
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 10.89
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 16.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 12.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 12.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 14.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.24
            }
          ]
        }
      ]
    },
    {
      "description": "INV IXAZOMIB/PLACEBO 3 MG CAPSULE",
      "drug_information": {
        "unit": "3",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-491537",
          "type": "CDM"
        },
        {
          "code": "25600001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.65,
          "discounted_cash": 0.42,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            }
          ]
        }
      ]
    },
    {
      "description": "INV PALBOCICLIB 75 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-491643",
          "type": "CDM"
        },
        {
          "code": "25600001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.65,
          "discounted_cash": 0.42,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 0.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 0.41
            }
          ]
        }
      ]
    },
    {
      "description": "METOCLOPRAMIDE 10 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-5005",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.05,
          "discounted_cash": 3.93,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.99
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.05
            }
          ]
        }
      ]
    },
    {
      "description": "METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "5",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-5007",
          "type": "CDM"
        },
        {
          "code": "J3490",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 35.05,
          "discounted_cash": 22.78,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.74
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.74
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.59
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.29
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.28
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 30.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 22.78
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 23.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.59
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.29
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.15
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.28
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.28
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.59
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.05,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.5
            }
          ]
        }
      ]
    },
    {
      "description": "NAFCILLIN 1 GRAM SOLUTION FOR INJECTION",
      "drug_information": {
        "unit": "4",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-5333",
          "type": "CDM"
        },
        {
          "code": "j3490",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 47.3,
          "discounted_cash": 30.74,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 39.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.14
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 39.21
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 30,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 39.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 30,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 31.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 38.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 30,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 30,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 41.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 30,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 30,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 30,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 41.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 30,
              "estimated_amount": 14.19
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 38.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 47.3,
              "additional_payer_notes": "INFUSION"
            }
          ]
        }
      ]
    },
    {
      "description": "PHENOBARBITAL 32.4 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-6217",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.25,
          "discounted_cash": 6.01,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.01
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.02
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.67
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.86
            }
          ]
        }
      ]
    },
    {
      "description": "PROPARACAINE 0.5 % EYE DROPS",
      "drug_information": {
        "unit": "15",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-6644",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 138.6,
          "discounted_cash": 90.09,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 105.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 105.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 121.55
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 76.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 112.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 101.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 113.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 90.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 87.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 76.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 87.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 76.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 101.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 76.92
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 90.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 87.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 105.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 76.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 113.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 76.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 114.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 76.23
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 101.18
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 37.84
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 101.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 138.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 114.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 89.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.04
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 87.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 121.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 103.95
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 113.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 113.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 90.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 112.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 89.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 103.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 87.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 76.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 101.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 101.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 76.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 76.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 87.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 105.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 105.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 90.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 87.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 76.23
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 113.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 87.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 113.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 90.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 105.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 89.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 113.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 114.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 89.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.98
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 91.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 113.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 90.23
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 121.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 88.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 87.04
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 138.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 103.95
            }
          ]
        }
      ]
    },
    {
      "description": "SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-7536",
          "type": "CDM"
        },
        {
          "code": "J0330",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 35.25,
          "discounted_cash": 22.91,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.93
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.52
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.96
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.58,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.96
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.58,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 28.52
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 31.02
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.58,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.58,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.58,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.93
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.96
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 23.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.91
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 26.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.58,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 26.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.96
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.96
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.73
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.58,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.91
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.39
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 9.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.9,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.9,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.58,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 19.39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 22.91
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.9,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.58,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.58,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.58,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 29.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 22.28
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.58,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.96
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 25.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.9,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.58,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.58,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.58,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 30.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.58,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.91
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 29.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 22.63
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 1.9,
              "estimated_amount": 1.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.58,
              "estimated_amount": 4.58
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 28.91
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 35.25,
              "additional_payer_notes": "OPPS APC"
            }
          ],
          "minimum": 1.9,
          "maximum": 4.58
        }
      ]
    },
    {
      "description": "SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-7555",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.05,
          "discounted_cash": 3.28,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.09
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.79
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.69
            }
          ]
        }
      ]
    },
    {
      "description": "FLUTICASONE PROPIONATE 115 MCG-SALMETEROL 21 MCG/ACTUATION HFA INHALER",
      "drug_information": {
        "unit": "0.000272",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-77174",
          "type": "CDM"
        },
        {
          "code": "J3535",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.65,
          "discounted_cash": 5.62,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.63
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.62
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.71
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.09
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.65,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM",
      "drug_information": {
        "unit": "15",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-8113",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 13.7,
          "discounted_cash": 8.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.23
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 12.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 9.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 13.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.23
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.92
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11.23
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 8.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 12.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 12.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 8.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8.92
            }
          ]
        }
      ]
    },
    {
      "description": "TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION",
      "drug_information": {
        "unit": "1",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-8120",
          "type": "CDM"
        },
        {
          "code": "J3301",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 43.55,
          "discounted_cash": 28.31,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.52
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.11,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.52
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.27
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 28.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.96
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.11,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.52
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.11,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.1
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.71
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 38.19
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.71
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.96
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 38.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 33.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.11,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.96
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 35.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 35.23
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 11.89
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 36.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.71
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 27.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 32.66
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 28.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 37.02
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.11,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 27.52
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 35.71
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 43.55,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 38.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 31.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 28.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 23.95
            }
          ],
          "minimum": 9.76,
          "maximum": 10.11
        },
        {
          "setting": "outpatient",
          "gross_charge": 76.4,
          "discounted_cash": 49.66,
          "payers_information": [
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 61.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.37
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.11,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.05
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.74
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.05
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 50.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 63.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.28
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 62.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.05
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 57.3
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 62.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 62.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.05
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.28
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.05
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 63.34
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 57.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.77
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.37
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 67.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 58.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.28
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.11,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 49.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.11,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 49.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 63.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 62.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 42.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.11,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 48.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 57.3
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 20.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 62.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 62.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 55.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 62.65
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 9.76,
              "estimated_amount": 9.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 62.65
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 49.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10.11,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 76.4,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 64.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 61.81
            }
          ],
          "minimum": 9.76,
          "maximum": 10.11
        }
      ]
    },
    {
      "description": "AMBRISENTAN 5 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-82307",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 115.75,
          "discounted_cash": 75.24,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 73.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 72.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 101.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 95.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 73.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 75.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 72.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 88.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 84.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 64.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 75.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 64.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 64.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 94.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 75.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 72.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 88.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 84.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 94.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 93.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 72.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 64.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 93.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 115.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 95.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 75.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 72.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 63.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 63.66
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 86.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 94.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 63.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 72.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 73.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 75.35
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 76.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 72.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 84.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 63.66
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 94.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 88.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 88.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 75.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 84.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 73.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 101.51
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.39
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.39
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 31.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 73.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 72.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 75.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 75.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 72.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 94.92
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 75.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 72.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 88.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 73.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.31
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 73.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 95.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 94.92
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 73.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 84.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 75.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 72.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 72.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 63.66
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 101.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 94.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 94.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 86.81
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 74.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 88.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 63.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.39
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 115.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 84.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 86.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 72.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 63.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 98.39
            }
          ]
        }
      ]
    },
    {
      "description": "TROPICAMIDE 1 % EYE DROPS",
      "drug_information": {
        "unit": "15",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-8250",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 126.8,
          "discounted_cash": 82.42,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 96.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 80.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 82.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 69.74
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 82.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 69.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 69.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 95.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 80.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 92.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 103.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 79.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 79.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 92.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 103.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 103.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 105.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 103.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 69.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 96.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 111.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.78
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 95.1
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 83.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 96.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 80.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 92.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 82.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 79.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 103.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 102.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 95.1
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.78
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 92.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 105.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 82.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 79.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 79.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 79.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 126.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 79.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 82.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 79.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 111.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 79.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 102.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 82.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 80.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 69.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 92.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 103.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 96.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 79.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 96.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 70.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 82.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 82.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 80.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 69.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 80.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 80.14
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 34.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 70.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 82.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 103.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 96.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 70.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.41
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 92.56
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.78
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 82.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 70.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 79.63
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 126.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 79.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 103.98
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 111.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 80.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 79.63
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.78
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 105.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 69.74
            }
          ]
        }
      ]
    },
    {
      "description": "WARFARIN 2 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-8749",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5,
          "discounted_cash": 3.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.05
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.82
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.39
            }
          ]
        }
      ]
    },
    {
      "description": "ALBENDAZOLE 200 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-8979",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 69.05,
          "discounted_cash": 44.88,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.33
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 51.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 69.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 44.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.98
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 18.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 38.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 60.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 44.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.33
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 45.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 57.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 38.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 55.86
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 51.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 60.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 60.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 38.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.62
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.69
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 44.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.64
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.69
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 69.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.98
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.33
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 51.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 57.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 57.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 37.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 55.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 52.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 44.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 50.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.62
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 44.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 43.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 38.32
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 44.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 43.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 56.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 44.95
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 58.69
            }
          ]
        }
      ]
    },
    {
      "description": "ALTEPLASE 50 MG INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "50",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-9003",
          "type": "CDM"
        },
        {
          "code": "J2997",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 17919.65,
          "discounted_cash": 11647.77,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11504.42
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9855.81
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15231.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9855.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9855.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11504.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11504.42
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13439.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12376.5,
              "estimated_amount": 12376.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12376.5,
              "estimated_amount": 12376.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9855.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11325.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12376.5,
              "estimated_amount": 12376.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12376.5,
              "estimated_amount": 12376.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15231.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13081.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14855.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15231.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11504.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11325.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14694.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12376.5,
              "estimated_amount": 12376.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12376.5,
              "estimated_amount": 12376.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12376.5,
              "estimated_amount": 12376.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12376.5,
              "estimated_amount": 12376.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13081.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14497
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14694.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14694.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11325.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12376.5,
              "estimated_amount": 12376.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13439.74
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 11647.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13690.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13690.61
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15231.7
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 17919.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13690.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12376.5,
              "estimated_amount": 12376.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 17919.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9855.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13081.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13081.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10391.94,
              "estimated_amount": 10391.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14497
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15231.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15231.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14694.11
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11325.22
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13439.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12376.5,
              "estimated_amount": 12376.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11665.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11665.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15231.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11325.22
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4892.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15715.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11665.69
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15231.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15231.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14694.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11665.69
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12376.5,
              "estimated_amount": 12376.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9855.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11504.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10391.94,
              "estimated_amount": 10391.94
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14694.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14694.11
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 15769.29
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11504.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11504.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15715.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12376.5,
              "estimated_amount": 12376.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12376.5,
              "estimated_amount": 12376.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10391.94,
              "estimated_amount": 10391.94
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 17919.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11504.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11504.42
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 11826.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14855.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12376.5,
              "estimated_amount": 12376.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 3225.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9855.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11504.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13690.61
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 3924.4
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15231.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 3225.54
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11325.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13081.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10391.94,
              "estimated_amount": 10391.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11665.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11504.42
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4569.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15231.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11325.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11325.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11504.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13690.61
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12376.5,
              "estimated_amount": 12376.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 10391.94,
              "estimated_amount": 10391.94
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 12376.5,
              "estimated_amount": 12376.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15231.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13690.61
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4352.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13081.34
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15231.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14694.11
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15231.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 14855.39
            }
          ],
          "minimum": 10391.94,
          "maximum": 12376.5
        }
      ]
    },
    {
      "description": "CAPTOPRIL 50 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-9403",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.1,
          "discounted_cash": 6.56,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.28
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.28
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.1,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.34
            }
          ]
        }
      ]
    },
    {
      "description": "CEFOTETAN 2 GRAM SOLUTION FOR INJECTION",
      "drug_information": {
        "unit": "20",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-9460",
          "type": "CDM"
        },
        {
          "code": "J3490",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 126.2,
          "discounted_cash": 82.03,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 96.42
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 103.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.02
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 69.41
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 110.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 82.16
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 79.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 96.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 102.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 79.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 92.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 92.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 104.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 79.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 110.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 69.41
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "INFUSION"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 79.76
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 69.41
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 94.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 103.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 82.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 69.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 92.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.02
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 103.48
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 103.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 102.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 79.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 79.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 96.42
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 103.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.27
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 83.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 96.42
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 34.45
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 104.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.02
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 92.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 92.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 96.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.02
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 69.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 96.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 104.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 79.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 94.65
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 103.48
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 82.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 103.48
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 82.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 69.41
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 82.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.27
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 79.76
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 69.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 103.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 92.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 82.16
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 107.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 81.02
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 111.06
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 94.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "SRD"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 126.2,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "CEFTRIAXONE 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOT) INTRAVENOUS PIGGYBACK",
      "drug_information": {
        "unit": "50",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-9492",
          "type": "CDM"
        },
        {
          "code": "J0696",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 106.75,
          "discounted_cash": 69.39,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.56
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.56
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.49
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.21,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.74
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.74
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 80.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 80.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.49
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.47
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.74
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.74
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 77.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.21,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 88.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 86.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.53
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 93.94
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 70.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 77.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.47
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 69.39
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.74
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 77.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 88.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.54
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 93.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 77.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.47
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.74
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 23.52,
              "estimated_amount": 23.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.53
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.21,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 67.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 77.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.74
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 80.06
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 58.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 77.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.21,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 69.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 88.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 86.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 81.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.21,
              "estimated_amount": 4.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 68.53
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 93.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 106.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 90.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 87.54
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 29.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 4.76,
              "estimated_amount": 4.76
            }
          ],
          "minimum": 4.21,
          "maximum": 23.52
        }
      ]
    },
    {
      "description": "CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH",
      "drug_information": {
        "unit": "15",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-9516",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.65,
          "discounted_cash": 6.27,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.26
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.06
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.65,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.06
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.1
            },
            {
              "payer_name": "OSU [553]",
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              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
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              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
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              "standard_charge_percentage": 73,
              "estimated_amount": 7.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
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              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.06
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 8.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
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              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 5.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 7.91
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.28
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.46
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
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              "standard_charge_percentage": 88,
              "estimated_amount": 8.49
            },
            {
              "payer_name": "SEORMC [545]",
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              "standard_charge_percentage": 66,
              "estimated_amount": 6.37
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.2
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
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              "standard_charge_percentage": 100,
              "estimated_amount": 9.65
            }
          ]
        },
        {
          "setting": "outpatient",
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          "discounted_cash": 15.92,
          "payers_information": [
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              "payer_name": "AHPO [305]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 20.83
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.48
            },
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              "payer_name": "GREATWEST [550]",
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              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.31
            },
            {
              "payer_name": "UHC [625]",
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              "estimated_amount": 15.39
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              "payer_name": "AETNA [310]",
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              "estimated_amount": 18.72
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            {
              "payer_name": "HEALTHREACH [540]",
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              "standard_charge_percentage": 55,
              "estimated_amount": 13.48
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            {
              "payer_name": "PARAMOUNT [555]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 20.83
            },
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              "payer_name": "OSU [553]",
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              "estimated_amount": 17.89
            },
            {
              "payer_name": "MMO [485]",
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              "estimated_amount": 15.48
            },
            {
              "payer_name": "UHC [625]",
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              "estimated_amount": 15.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "estimated_amount": 20.09
            },
            {
              "payer_name": "HUMANA [465]",
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              "estimated_amount": 15.93
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "estimated_amount": 13.48
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              "payer_name": "OSU [553]",
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              "estimated_amount": 17.89
            },
            {
              "payer_name": "HEALTHLINK [443]",
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              "standard_charge_percentage": 75,
              "estimated_amount": 18.38
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 87.7,
              "estimated_amount": 21.49
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "CIGNA [370]",
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              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
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              "standard_charge_percentage": 87.7,
              "estimated_amount": 21.49
            },
            {
              "payer_name": "COFINITY [407]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 20.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "standard_charge_percentage": 82,
              "estimated_amount": 20.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
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              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "GREATWEST [550]",
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              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
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              "estimated_amount": 13.48
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.73
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
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              "standard_charge_percentage": 85,
              "estimated_amount": 20.83
            },
            {
              "payer_name": "AETNA [310]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
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              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.73
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
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              "standard_charge_percentage": 27.3,
              "estimated_amount": 6.69
            },
            {
              "payer_name": "MMO [485]",
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              "estimated_amount": 15.48
            },
            {
              "payer_name": "AETNA [310]",
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              "estimated_amount": 18.72
            },
            {
              "payer_name": "OSU [553]",
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              "estimated_amount": 17.89
            },
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              "payer_name": "OHIO HEALTH CHOICE [535]",
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              "estimated_amount": 20.09
            },
            {
              "payer_name": "UHC [625]",
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              "standard_charge_percentage": 64.9,
              "estimated_amount": 15.9
            },
            {
              "payer_name": "MMO [485]",
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              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.48
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 21.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.48
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 24.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.09
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 15.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.83
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.73
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 16.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 15.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 20.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 19.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.73
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 20.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 13.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 18.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.48
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 24.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 17.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 15.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 18.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 20.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 13.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 15.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 15.48
            }
          ]
        }
      ]
    },
    {
      "description": "CLOMIPRAMINE 25 MG CAPSULE",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-9635",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.5,
          "discounted_cash": 3.57,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.57
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.57
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.03
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.5,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "CLONAZEPAM 0.5 MG TABLET",
      "drug_information": {
        "unit": "1",
        "type": "UN"
      },
      "code_information": [
        {
          "code": "RX-9637",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.7,
          "discounted_cash": 6.3,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.09
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 6.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 6.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.23
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.65
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.85
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.31
            }
          ]
        }
      ]
    },
    {
      "description": "COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT",
      "drug_information": {
        "unit": "30",
        "type": "GR"
      },
      "code_information": [
        {
          "code": "RX-9682",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1099.3,
          "discounted_cash": 714.54,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 839.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 839.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 705.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 694.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 901.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 934.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 901.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 802.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 690.36
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 300.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 802.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 610.11
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 967.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 901.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 715.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 690.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 694.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 690.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 715.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 839.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 690.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 713.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 824.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 705.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 690.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 713.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 964.09
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 934.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 901.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 705.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 610.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 690.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 705.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 901.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 889.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 690.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 705.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 911.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 715.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 901.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 604.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 839.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 705.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 690.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 694.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 802.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 934.41
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 934.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 705.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 802.49
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 934.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 604.62
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1099.3,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1099.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 802.49
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 714.55
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 934.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 604.62
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 934.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 911.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 715.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 705.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 824.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 713.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 694.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 610.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 715.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 604.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 839.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 705.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 964.09
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 934.41
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 725.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 694.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 690.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 901.43
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 824.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 694.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 690.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 690.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 911.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 694.76
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 934.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 705.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 705.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 690.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 690.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 839.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 694.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 713.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 610.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 889.33
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 934.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 604.62
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 934.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 934.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 604.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 604.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 705.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 802.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 901.43
            }
          ]
        }
      ]
    },
    {
      "description": "CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS",
      "drug_information": {
        "unit": "2",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-9701",
          "type": "CDM"
        },
        {
          "code": "63700001",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 131.9,
          "discounted_cash": 85.73,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 73.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 85.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 82.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 85.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 82.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 109.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 85.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 131.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 100.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 82.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 115.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 100.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.36
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 82.83
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 131.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 85.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 73.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 98.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 82.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 115.68
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 116.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 100.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 85.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 85.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.36
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 100.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 82.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 73.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 106.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 82.83
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.68
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 87.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.68
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 98.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 106.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 109.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 82.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 82.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.68
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 82.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 85.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.29
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 85.74
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.12
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 36.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 82.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 109.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 108.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 82.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 100.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 85.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 85.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 73.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.36
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 112.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 98.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 96.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 100.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 82.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 83.36
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 72.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 84.68
            }
          ]
        }
      ]
    },
    {
      "description": "ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION",
      "drug_information": {
        "unit": "10",
        "type": "ML"
      },
      "code_information": [
        {
          "code": "RX-9957",
          "type": "CDM"
        },
        {
          "code": "J1805",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 63.8,
          "discounted_cash": 41.47,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7,
              "estimated_amount": 7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.96
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.53
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.23
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.8,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.15,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7,
              "estimated_amount": 7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.15,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7,
              "estimated_amount": 7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7,
              "estimated_amount": 7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.15,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7,
              "estimated_amount": 7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.32
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7,
              "estimated_amount": 7
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.15,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.32
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.32
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7,
              "estimated_amount": 7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.74
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.57
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7,
              "estimated_amount": 7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7,
              "estimated_amount": 7
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 42.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 52.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.96
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7,
              "estimated_amount": 7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.57
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 5.15,
              "estimated_amount": 5.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7,
              "estimated_amount": 7
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.32
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7,
              "estimated_amount": 7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 41.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7,
              "estimated_amount": 7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7,
              "estimated_amount": 7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7,
              "estimated_amount": 7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 55.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7,
              "estimated_amount": 7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 48.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 47.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.57
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.42
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 63.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 40.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "fee schedule",
              "standard_charge_dollar": 7,
              "estimated_amount": 7
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 56.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 51.61
            }
          ],
          "minimum": 5.15,
          "maximum": 7
        }
      ]
    },
    {
      "description": "CARRIER 3-TO-1 SKIN GRAFT STERL",
      "code_information": [
        {
          "code": "SUP-00-2195-013-00",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 104.4,
          "discounted_cash": 67.86,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 76.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 84.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 67.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.61
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 67.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 57.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.98
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 78.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.61
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.96
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.74
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 91.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 76.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 91.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 86.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.61
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 78.3
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 76.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.42
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 76.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.98
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.02
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 104.4,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 57.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 76.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 57.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 84.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.56
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 86.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 86.55
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.74
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.02
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 28.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 91.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 67.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 57.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 85.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 76.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 67.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 67.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.98
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 88.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 104.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 78.3
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 68.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 65.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 57.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 65.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 79.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 67.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 67.76
            }
          ]
        }
      ]
    },
    {
      "description": "ARTICULAR SURF CD 6-9 11MM RT POLY PS PERSONA",
      "code_information": [
        {
          "code": "SUP-42-5214-005-11",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1639.8,
          "discounted_cash": 1065.87,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1252.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1051.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1393.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1047.83
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1393.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1000.28
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1359.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1067.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1051.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1252.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 901.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 901.89
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1074.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1000.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 901.89
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1326.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1074.07
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1393.83
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1443.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1344.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1051.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1252.81
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 910.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1344.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1344.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1000.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1000.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1051.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1393.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1359.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1438.1
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1393.83
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1393.83
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1065.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1051.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1051.11
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1197.05
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1051.11
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1393.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1344.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1000.28
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1197.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1344.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1074.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1000.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1000.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1000.28
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1393.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1051.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1051.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1344.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1074.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1197.05
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1197.05
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 901.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1051.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1393.83
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1393.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1252.81
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1229.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 910.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1067.51
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1393.83
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1074.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1074.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1359.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1000.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1000.28
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1393.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1344.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1074.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1074.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1252.81
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1082.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1197.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1639.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1067.51
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 447.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1000.28
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1051.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1000.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1047.83
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1197.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1326.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1229.85
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 359.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1393.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 901.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 910.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1051.11
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1000.28
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 901.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 910.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1067.51
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 901.89
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1393.83
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1047.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1047.83
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1229.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1252.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1067.51
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1639.8,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1438.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1344.64
            }
          ]
        }
      ]
    },
    {
      "description": "GRAFT 1CC MATRIX BIOCARTILAGE",
      "code_information": [
        {
          "code": "SUP-ABS-1010-BC",
          "type": "CDM"
        },
        {
          "code": "C1762",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2940,
          "discounted_cash": 1911,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1884.54
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1925.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1793.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1617
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1884.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1884.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1884.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2246.16
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1940.4
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1925.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2410.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2499
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1631.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2410.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2146.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2146.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2410.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2499
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2499
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1925.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2578.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2146.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1913.94
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1878.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1793.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1793.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1617
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1884.54
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2205
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2578.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1925.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1925.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1884.54
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1913.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1925.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2246.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1793.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2410.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2410.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2499
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 643.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1793.4
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2146.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1884.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1793.4
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1617
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2146.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2410.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1913.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1793.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1878.66
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 802.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1793.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1793.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1631.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2437.26
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2499
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1884.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2499
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2205
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1884.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1884.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2146.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2410.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1793.4
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2499
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1878.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2437.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1925.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1884.54
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1925.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1911
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1793.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1617
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2499
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2378.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2246.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1617
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2499
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2499
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1884.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2499
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1793.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2246.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2246.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2499
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2205
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1878.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2378.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1913.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1631.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2940
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2410.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1617
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1617
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2499
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2499
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1793.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2246.16
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2587.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1913.94
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2940,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1631.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2437.26
            }
          ]
        }
      ]
    },
    {
      "description": "NAIL 12MM X 240MM LT TI HINDFOOT ARTHRO CANN EX",
      "code_information": [
        {
          "code": "SUP-04.008.278S",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3339.84,
          "discounted_cash": 2170.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2140.84
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2929.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2134.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2187.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1853.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2140.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2438.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2187.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2037.3
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2551.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2174.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2140.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2551.64
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2838.86
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1836.91
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2838.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2738.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2438.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2438.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2738.67
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2504.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2037.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2768.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2187.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2187.6
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2701.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2037.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1836.91
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1853.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2738.67
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 731.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1836.91
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2838.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2140.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2140.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2551.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2768.73
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2204.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2187.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2134.16
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2838.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2738.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2738.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2037.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2438.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1836.91
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2134.16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3339.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2140.84
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2838.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2140.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2551.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2438.08
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2037.3
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 911.78
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2838.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2037.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2838.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2037.3
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2838.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1853.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2738.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2738.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2187.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2187.6
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2838.86
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2838.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2140.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2838.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2504.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2140.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2174.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2037.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2037.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1836.91
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2551.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2551.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2037.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2174.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2037.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1836.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2701.93
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2187.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1836.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2134.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2838.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2174.24
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2838.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2140.84
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2170.9
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2939.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2037.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2738.67
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1853.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2438.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2929.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2037.3
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2140.84
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2504.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2838.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2768.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2174.24
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3339.84,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2140.84
            }
          ]
        }
      ]
    },
    {
      "description": "CATH 90CM PERITONEAL OPEN END W/WALL SLITS",
      "code_information": [
        {
          "code": "SUP-43522",
          "type": "CDM"
        },
        {
          "code": "C1729",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 458.28,
          "discounted_cash": 297.88,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 254.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 254.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 389.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.05
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 401.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 379.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 298.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 350.13
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 334.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 334.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 375.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 298.34
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 389.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 379.91
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 350.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 297.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 375.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 375.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 254.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 379.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 389.54
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 289.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 375.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 370.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 389.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 375.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 298.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 343.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.22
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 389.54
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 302.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 458.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 350.13
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 343.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 334.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 298.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 289.63
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 389.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 289.63
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 375.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 370.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 389.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 289.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 334.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 289.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 389.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 389.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 401.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 289.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 334.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 254.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 334.54
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 350.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 343.71
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 389.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.22
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 289.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 389.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 389.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 375.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 298.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 289.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 375.79
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 125.11
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 389.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 458.28,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 350.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 350.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.22
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 403.29
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 389.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.05
            }
          ]
        }
      ]
    },
    {
      "description": "DEVICE CLOSURE TROCAR SITE ENDOCLOSE",
      "code_information": [
        {
          "code": "SUP-173022",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 55.02,
          "discounted_cash": 35.76,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.32
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 30.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 30.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 45.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 44.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.32
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 36.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 48.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 30.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 41.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 35.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 35.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 35.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 55.02,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 45.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 30.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 55.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.32
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 41.27
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.32
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.77
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 44.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.82
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 41.27
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.32
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 15.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 35.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 48.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.26
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 45.61
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 35.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 48.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 35.82
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 46.77
            }
          ]
        }
      ]
    },
    {
      "description": "CLAMP 5MM BABCOCK ENDOSCOPIC",
      "code_information": [
        {
          "code": "SUP-5BB",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 161.39,
          "discounted_cash": 104.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 101.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.76
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 133.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 105.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 121.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 105.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.61
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 121.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 101.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.76
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 104.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 105.06
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 101.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.76
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 104.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 133.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 105.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 104.74
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 142.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 130.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 102
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 123.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 101.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 104.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 89.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 89.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 102
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 102
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 123.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 101.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 101.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 123.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 141.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 123.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.18
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 130.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 101.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 161.39
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 44.06
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 102
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 105.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 101.35
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 121.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 117.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 123.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 102
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 141.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 101.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 123.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 102
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.18
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 161.39,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 133.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 102
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 101.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 89.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 103.61
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 106.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 101.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 89.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 101.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 104.74
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 101.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 132.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 102
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 137.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 88.76
            }
          ]
        }
      ]
    },
    {
      "description": "LINER 36MM SZ D ACET FREEDOM CONSTRAINED E1 G7",
      "code_information": [
        {
          "code": "SUP-010000982",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8427.51,
          "discounted_cash": 5477.88,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5402.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5385.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6438.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4677.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5486.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5486.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6438.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4635.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5520.02
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5477.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5140.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1516.95
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6320.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5402.03
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5520.02
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7163.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5140.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1516.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6438.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6438.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6910.56
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6986.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5486.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5140.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5140.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5520.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6910.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5402.03
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5402.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5402.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6152.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5486.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5140.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5385.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4677.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5385.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5140.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4635.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5402.03
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5140.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7163.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6986.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5520.02
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7163.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6152.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6910.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5402.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6152.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6910.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6152.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6986.41
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7390.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5520.02
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1845.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5402.03
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7163.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6910.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5486.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6438.62
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7163.38
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7163.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4677.27
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5140.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4635.13
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2300.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5520.02
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7163.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5402.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6320.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6817.86
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4635.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7163.38
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7163.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6438.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4635.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6910.56
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6152.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4677.27
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5385.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5402.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7163.38
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5562.16
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8427.51
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5402.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5140.78
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7163.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5140.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5140.78
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6152.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6910.56
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7163.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4635.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4635.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5520.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6320.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5520.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6910.56
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8427.51,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7163.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5140.78
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7416.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5402.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6817.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 5140.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7390.93
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7163.38
            }
          ]
        }
      ]
    },
    {
      "description": "SUTURE 3-0 45CM STRATAFIX MONOCRYL PLUS SXMP1B102 PS-1",
      "code_information": [
        {
          "code": "SUP-SXMP1B102",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 88.55,
          "discounted_cash": 57.56,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 67.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 49.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 55.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 73.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 55.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 71.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 57.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 55.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 55.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 55.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 57.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 55.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 55.61
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 24.17
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 57.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 55.96
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 88.55,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 67.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 57.47
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 55.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 77.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 55.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 57.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 55.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 67.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 49.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 57.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 71.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 55.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 55.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 57.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 49.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 55.61
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 58.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 55.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 67.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 73.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 57.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 73.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 72.61
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 55.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 55.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 64.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 55.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 77.66
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 49.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 67.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 57.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 66.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 55.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 55.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.85
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 55.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 88.55
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 77.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 57.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 66.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 48.7
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 67.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 56.85
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 75.27
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 66.41
            }
          ]
        }
      ]
    },
    {
      "description": "SUTURE 0 8IN V-LOC 180 DEVICE RELOAD",
      "code_information": [
        {
          "code": "SUP-VLOCA008L",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 319.77,
          "discounted_cash": 207.85,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 244.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 202.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 233.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 208.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 208.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 262.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 244.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 244.3
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 207.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 207.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 175.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 244.3
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 175.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 200.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 258.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 239.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 207.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 200.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 262.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.29
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 175.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 262.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 262.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 233.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 200.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 175.87
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 319.77,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 280.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 258.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 207.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 200.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 177.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 208.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 233.43
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 281.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.8
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 200.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 233.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 202.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 202.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 207.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 202.09
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 262.21
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 200.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 177.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 262.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 177.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 208.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 202.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 202.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 280.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 175.87
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 239.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 177.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 265.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 200.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 200.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.29
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 211.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 200.82
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 271.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 265.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 265.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 262.21
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 239.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.29
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 87.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 202.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 202.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 200.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 200.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 319.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 244.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 200.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 262.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 208.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 200.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 175.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 233.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 244.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 205.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 233.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 175.87
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 3.5 X 28MM FULL THRD T10 VARIAX 2",
      "code_information": [
        {
          "code": "SUP-657428",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 408,
          "discounted_cash": 265.2,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 261.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 346.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 265.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 248.88
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 111.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 226.44
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 346.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 311.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 226.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 265.61
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 346.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 224.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 346.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 248.88
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 359.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 261.53
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 265.2
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 346.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 267.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 248.88
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 261.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 261.53
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 269.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 260.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 248.88
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 267.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 334.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 261.53
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 267.24
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 408,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 408,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 226.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 297.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 408
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 226.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 260.71
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 306
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 408,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 224.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 224.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 261.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 248.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 224.4
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 357.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 297.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 338.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 334.56
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 408,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 338.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 334.56
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 346.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 248.88
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 267.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 334.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 311.71
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 346.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 297.84
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 346.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 267.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 248.88
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 408,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 297.84
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 338.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 330.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 260.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 224.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 261.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 311.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 306
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 261.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 261.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 267.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 334.56
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 248.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 311.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 248.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 346.8
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 306
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 330.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 248.88
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 267.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 357.82
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 346.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 346.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 265.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 248.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 261.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 346.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 267.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 311.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 334.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 265.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 311.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 261.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 248.88
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 408,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 297.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 224.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 265.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 261.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 260.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 224.4
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 346.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 334.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 248.88
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 346.8
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 408,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 334.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 297.84
            }
          ]
        }
      ]
    },
    {
      "description": "PLATE 37MM 2LVL TEMPUS",
      "code_information": [
        {
          "code": "SUP-10-02-037",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2025,
          "discounted_cash": 1316.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1298.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1660.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1235.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1721.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1721.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1721.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1678.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1318.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1298.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1326.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1293.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1293.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1123.88
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1721.25
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 552.83
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1721.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1478.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1660.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1721.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1113.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1123.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1660.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1113.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1678.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1660.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1318.28
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1721.25
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1235.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1113.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1478.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1478.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1298.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1518.75
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1235.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1775.93
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1113.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1721.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1660.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1318.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1678.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1298.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1547.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1113.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1235.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1235.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1298.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1547.1
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1113.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1518.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1298.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1298.03
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1316.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1721.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1298.03
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1478.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1326.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1326.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1547.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1326.38
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1782
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1298.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1775.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1326.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1235.25
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1660.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1547.1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1318.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1235.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1235.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1293.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1298.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1721.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1721.25
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 443.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1235.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1235.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1113.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1547.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1235.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1721.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1638.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1123.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1318.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1326.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1298.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1293.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1478.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1326.38
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1518.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1660.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1298.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1721.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1235.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1123.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1660.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2025
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1235.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2025,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1547.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1721.25
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1336.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1326.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1478.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1638.23
            }
          ]
        }
      ]
    },
    {
      "description": "CUFF FOOT SCD COMPRESSION REGULAR WRAP",
      "code_information": [
        {
          "code": "SUP-5897",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 47.07,
          "discounted_cash": 30.6,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 26.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 26.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 47.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 39.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 38.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.89
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 12.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.22
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 31.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 30.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 39.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 41.28
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 41.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.22
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 47.07,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.89
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 30.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 26.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 35.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 35.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.22
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 38.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 41.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 30.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 30.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 35.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 30.55
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 35.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 29.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 26.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 39.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.6
            }
          ]
        }
      ]
    },
    {
      "description": "HEAD 45 X 19MM HUM LOW OFFSET STB COCR ASCEND FLEX",
      "code_information": [
        {
          "code": "SUP-DWG047",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6132,
          "discounted_cash": 3985.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3930.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5028.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3991.93
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5212.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4476.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4476.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5212.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3991.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3930.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5028.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5212.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4016.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5212.2
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3740.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3403.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3991.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3930.61
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1342.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4684.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4684.85
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4960.79
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5212.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3740.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3740.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3918.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3372.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4476.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4476.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5028.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3991.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3930.61
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3930.61
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4599
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3740.52
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4016.46
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4599
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4016.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5377.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6132
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5028.24
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5212.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3740.52
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3930.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3740.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3372.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4684.85
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5212.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4960.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4016.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5212.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5377.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3930.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5212.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3918.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3372.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4016.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5028.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4684.85
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4016.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3740.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3740.52
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4599
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3372.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4016.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4016.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3740.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3403.26
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3403.26
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5212.2
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4684.85
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4476.36
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5212.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5083.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3740.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3372.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3930.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3930.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5212.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1103.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3930.61
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5396.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4684.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3918.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3930.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5083.43
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5212.2
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4047.12
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1674.04
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3985.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5028.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3930.61
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3403.26
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3740.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3991.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5083.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3740.52
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1103.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3372.6
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3740.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3372.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4476.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5028.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5028.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3918.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5212.2
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6132,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "EXTENDER 5 X 20MM BUTTON TIGHTROPE",
      "code_information": [
        {
          "code": "SUP-AR-1589RT",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 708.75,
          "discounted_cash": 460.69,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 541.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 454.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 454.31
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 602.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 517.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 602.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 389.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 389.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 581.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 581.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 454.31
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 602.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 541.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 393.36
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 602.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 454.31
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 602.44
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 464.23
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 193.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 541.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 708.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 432.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 454.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 587.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 461.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 541.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 454.31
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 531.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 517.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 581.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 461.4
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 602.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 454.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 432.34
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 541.49
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 573.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 464.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 454.31
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 581.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 461.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 464.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 432.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 452.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 517.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 573.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 452.89
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 623.7
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 393.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 581.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 621.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 389.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 432.34
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 602.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 464.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 464.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 541.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 581.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 454.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 602.44
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 432.34
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 581.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 581.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 461.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 432.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 432.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 389.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 389.81
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 389.81
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 393.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 432.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 432.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 432.34
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 602.44
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 602.44
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 467.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 464.23
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 531.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 432.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 452.89
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 587.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 517.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 587.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 461.4
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 452.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 454.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 602.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 517.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 602.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 464.23
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 621.57
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 517.39
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 460.69
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 602.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 432.34
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 454.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 454.31
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 708.75,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 531.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 393.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 464.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 432.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 389.81
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 602.44
            }
          ]
        }
      ]
    },
    {
      "description": "NEEDLE 35CM 25GA 6FR FLEXIBLE CYSTOSCOPE INJECTION INJETAK",
      "code_information": [
        {
          "code": "SUP-DIS199",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 208.5,
          "discounted_cash": 135.52,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 159.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 130.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 131.77
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 130.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 135.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 131.77
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 115.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 170.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 170.97
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 156.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 130.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 133.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 170.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 130.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 130.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 133.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 130.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 152.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 135.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 115.72
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 172.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 172.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 152.21
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 137.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 135.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 135.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 130.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 159.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 156.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 130.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 133.86
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 133.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 168.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 135.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 152.21
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 56.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 130.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 170.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 208.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 135.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 168.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 130.94
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 182.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 133.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 156.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 130.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 135.32
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 133.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 133.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.68
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 133.86
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.23
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 208.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 152.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 159.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 131.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 170.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 159.29
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 135.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 115.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 170.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 135.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 159.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 133.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 135.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 131.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 131.77
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 133.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 133.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 159.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 170.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 182.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 130.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 114.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 115.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 131.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 131.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 133.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.23
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 177.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 152.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 172.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 170.97
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 183.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 152.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 131.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 130.94
            }
          ]
        }
      ]
    },
    {
      "description": "IRRIGATOR 8MM ENDOWRIST DAVINCI XI",
      "code_information": [
        {
          "code": "SUP-480299",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 835,
          "discounted_cash": 542.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 527.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 732.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 709.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 684.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 543.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 524.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 524.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 459.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 692.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 524.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 541.92
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 709.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 684.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 543.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 609.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 527.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 527.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 524.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 709.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 835,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 609.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 709.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 524.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 463.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 463.43
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 709.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 609.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 684.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 684.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 543.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 675.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 527.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 524.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 637.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 524.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 637.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 527.72
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 734.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 709.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 524.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 692.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 541.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 541.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 732.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 463.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 684.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 637.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 609.55
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 227.96
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 542.75
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 551.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 709.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 541.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.07
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 709.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 684.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 626.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 524.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 692.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 835
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 684.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 543.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 524.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 459.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 684.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 459.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 459.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.07
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 709.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 463.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 637.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 609.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 524.38
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 626.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 675.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 524.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 459.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 459.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 709.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 637.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 637.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 524.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 527.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 527.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 709.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 459.25
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 626.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 709.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 536.07
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 609.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 527.72
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 543.59
            }
          ]
        }
      ]
    },
    {
      "description": "NEUROSTIMULATOR BUNDLE W/ IPG PROGRAMMER RECHARGABLE",
      "code_information": [
        {
          "code": "SUP-9771IR",
          "type": "CDM"
        },
        {
          "code": "C1820",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 52920,
          "discounted_cash": 34398,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 33921.72
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34450.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29106
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40430.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38631.6
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44982
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44982
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44982
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 33921.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 39690
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 33921.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 34662.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32281.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 33815.88
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 9525.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44982
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 34662.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 33921.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 33921.72
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44982
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38631.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38631.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29370.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43394.4
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32281.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32281.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32281.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29106
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32281.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 9525.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 42812.28
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44982
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38631.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40430.88
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 43870.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34450.92
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 34662.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29106
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 33921.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 33815.88
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 33921.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 33815.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43394.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29106
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44982
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 46410.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 34662.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 33921.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40430.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 33921.72
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 33815.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29106
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 52920
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 34398
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34450.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43394.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43394.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34450.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32281.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44982
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40430.88
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38631.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43394.4
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44982
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 33921.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29370.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 34662.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 46410.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43394.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 33921.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44982
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43394.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40430.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29370.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 34662.6
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 14447.16
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44982
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 11589.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 39690
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 34927.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 38631.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 43394.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 34662.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32281.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 33921.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32281.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 39690
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32281.2
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44982
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32281.2
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 46569.6
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 52920,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44982
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32281.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29106
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 29370.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 43870.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 34450.92
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 44982
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 40430.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 34662.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 42812.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 29106
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32281.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 32281.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 43870.68
            }
          ]
        }
      ]
    },
    {
      "description": "DEVICE 5MM FIXATION W/25 ABSORBABLE SECURESTRAP",
      "code_information": [
        {
          "code": "SUP-STRAP25",
          "type": "CDM"
        },
        {
          "code": "C1781",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1236.89,
          "discounted_cash": 803.98,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 792.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 792.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.29
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.36
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 944.98
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 927.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 944.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 792.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 902.93
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 337.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 792.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 902.93
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1000.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.36
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 754.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 790.37
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1000.64
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 810.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 810.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 754.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 944.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.29
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.36
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 792.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 792.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1014.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 790.37
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 927.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 792.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1014.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 805.22
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.36
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 944.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 944.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 754.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1025.38
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 792.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 792.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 792.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 792.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 805.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 754.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.29
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 810.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 754.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 754.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 902.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 686.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 805.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 810.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 754.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.36
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 805.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1014.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1014.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.36
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 792.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 754.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 686.47
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 810.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 754.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.29
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 902.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 686.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1014.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 754.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 754.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 790.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1014.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1084.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1236.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 810.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 944.98
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.36
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1025.38
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 803.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 754.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 810.16
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 270.88
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.36
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 686.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 810.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1084.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 927.67
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1014.25
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 902.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1025.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 790.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.29
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 816.35
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 805.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 754.5
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1088.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1014.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1236.89,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 902.93
            }
          ]
        }
      ]
    },
    {
      "description": "DRAIN 10MM FLAT FULL CHANNELS",
      "code_information": [
        {
          "code": "SUP-JP2215",
          "type": "CDM"
        },
        {
          "code": "C1729",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 41.35,
          "discounted_cash": 26.88,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.92
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 36.26
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 41.35
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.74
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 11.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 34.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.13
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.19
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 26.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.13
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 33.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 27.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 36.39
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 36.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 30.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 34.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 33.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 33.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.13
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 26.55
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 26.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 22.74
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 41.35,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 35.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.13
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 31.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 31.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 26.13
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 22.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 34.28
            }
          ]
        }
      ]
    },
    {
      "description": "DRAIN 10MM WOUND FLAT FULL DUCT W/O TROCAR",
      "code_information": [
        {
          "code": "SUP-JPHUF100",
          "type": "CDM"
        },
        {
          "code": "C1729",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 45.61,
          "discounted_cash": 29.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.77
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 40
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.3
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.77
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.77
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 29.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.83
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.3
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 34.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 25.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.77
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 30.1
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 45.61
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 36.9
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 40.14
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.77
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 37.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 37.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.69
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 40
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 34.21
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.77
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 25.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 37.81
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 34.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 33.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 37.4
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 25.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 36.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 28.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 29.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 25.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 29.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 34.85
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 12.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 45.61,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 38.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 37.4
            }
          ]
        }
      ]
    },
    {
      "description": "WIRE PILOT NITINOL DISP",
      "code_information": [
        {
          "code": "SUP-5901-6072",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 219,
          "discounted_cash": 142.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 140.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 138.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 138.41
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 186.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 137.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 179.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 179.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 167.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 179.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 186.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 167.32
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 186.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 167.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 138.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 137.53
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 59.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 140.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 142.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 159.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 142.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 137.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 137.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 138.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 181.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 142.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 186.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 137.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 137.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 121.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 179.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 137.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 142.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 159.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 179.58
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 142.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 140.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 140.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 186.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 137.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 159.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 120.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 177.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 186.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 140.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 142.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 181.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 140.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 138.41
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 120.45
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 186.15
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 186.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 142.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 142.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 138.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 192.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 137.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 137.53
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 219,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 164.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 159.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 142.57
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 186.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 120.45
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 186.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 159.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 142.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 137.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 186.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 120.45
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 192.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 120.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 140.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 140.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 121.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 219
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 167.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 192.06
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 186.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 120.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 120.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 138.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 167.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 121.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 121.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 179.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 167.32
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 144.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 159.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 140.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 164.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 140.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 181.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 179.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 137.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 177.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 138.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 140.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 140.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 179.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 137.53
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 164.25
            }
          ]
        }
      ]
    },
    {
      "description": "DRESSING VAC ULTA VERAFLO MED 5/PK",
      "code_information": [
        {
          "code": "SUP-ULTVFL05MD",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 345,
          "discounted_cash": 224.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 221.49
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 293.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 218.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 293.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 216.66
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 258.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 282.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 221.49
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 293.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 223.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 216.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 218.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 216.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 279.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 224.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 218.04
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 345,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 216.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 221.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 191.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 223.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 218.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 282.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 221.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 216.66
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 293.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 221.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 221.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 216.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 216.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 282.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 224.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 293.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 251.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 191.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 293.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 224.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 302.57
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 224.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 218.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 189.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 191.48
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 286.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 218.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 302.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 282.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 218.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 216.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 251.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 263.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 263.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 221.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 221.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 286.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 224.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 189.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 293.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 293.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 223.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 218.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 221.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 189.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 251.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 286.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 251.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 263.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 293.25
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 94.19
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 227.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 282.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 282.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 224.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 263.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 216.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 216.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 189.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 263.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 221.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 221.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 221.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 279.11
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 258.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 216.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 216.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 251.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 191.48
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 293.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 223.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 293.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 189.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 216.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 189.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 189.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 263.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 345
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 293.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 251.85
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 303.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 282.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 282.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 258.75
            }
          ]
        }
      ]
    },
    {
      "description": "BIT 6.5 X 330MM DRILL CANN QC",
      "code_information": [
        {
          "code": "SUP-357047",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1434,
          "discounted_cash": 932.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 920.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1175.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1160.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 900.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1188.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 920.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1257.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 900.55
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 391.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1046.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1046.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 933.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 900.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 788.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1218.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 900.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 900.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 788.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 920.63
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1218.9
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1434,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1261.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1175.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 920.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1075.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1046.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 900.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 788.7
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1075.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1218.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1160.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 933.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 900.55
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1218.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1046.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 795.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1434
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1257.62
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1218.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 920.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1095.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 933.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 930.67
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 932.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1218.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1218.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 788.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 906.29
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1188.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 920.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1095.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 906.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 906.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 900.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 900.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 906.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1095.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 900.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 795.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1175.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 906.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 900.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1188.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1175.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1095.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1218.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1175.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1175.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1046.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 933.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 930.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 920.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 788.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1175.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 920.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1218.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 906.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 788.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1046.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 795.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1175.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 900.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 788.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 920.63
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1218.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 920.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1218.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1095.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 933.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 930.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1095.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 920.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 920.63
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 946.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 795.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 906.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1075.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1218.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 930.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 900.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 906.29
            }
          ]
        }
      ]
    },
    {
      "description": "ELECTRODE RTS W/QUIK-COMBO CONNECTOR",
      "code_information": [
        {
          "code": "SUP-22550R",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 55.34,
          "discounted_cash": 35.97,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.28
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 36.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.75
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 15.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 35.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.75
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 45.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.03
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 48.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 35.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.44
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.44
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 48.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 35.97
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.44
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 41.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 44.77
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.04
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 55.34,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 36.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 35.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 41.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 35.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 41.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 42.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 30.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 40.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 45.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 55.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 48.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 47.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 34.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 45.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 45.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 35.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 34.97
            }
          ]
        }
      ]
    },
    {
      "description": "ELIMINATOR HOLE PS",
      "code_information": [
        {
          "code": "SUP-124603000",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 165,
          "discounted_cash": 107.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 105.77
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 91.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 107.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 105.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 133.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 126.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 105.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 108.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 108.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 107.42
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 108.08
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 120.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 135.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 90.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 90.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 90.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 105.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 120.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 126.06
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 105.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 105.77
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 108.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 108.08
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 90.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 120.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 135.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 144.71
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 123.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 126.06
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 45.05
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 108.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 105.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 123.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 105.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 135.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 135.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 107.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 105.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.25
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 165,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 108.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 133.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 126.06
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 105.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 90.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 120.45
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 165
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 91.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 135.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 107.42
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.25
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 165,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 136.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 135.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 165,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 105.77
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 91.58
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 108.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 144.71
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 90.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 136.79
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 105.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 126.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 105.44
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 165,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 91.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 135.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 107.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 165,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 120.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 123.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 108.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 90.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 136.79
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 107.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 100.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 105.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 135.3
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 165,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 105.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 105.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 140.25
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 145.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 126.06
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 165,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 120.45
            }
          ]
        }
      ]
    },
    {
      "description": "COMPONENT SZ7 38MM PATELLA M-DOME SCORPIO",
      "code_information": [
        {
          "code": "SUP-73-0710",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 675,
          "discounted_cash": 438.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 515.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 432.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 506.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 675
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 439.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 431.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 431.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 411.75
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 371.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 411.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 553.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 573.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 432.68
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 445.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 442.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 442.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 492.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 546.08
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 371.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 442.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 559.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 431.33
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 675,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 371.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 432.68
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 573.75
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 411.75
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 675,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 374.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 374.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 442.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 432.68
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 573.75
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 371.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 432.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 374.63
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 573.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 573.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 573.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 411.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 573.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 573.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 553.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 546.08
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 438.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 591.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 432.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 492.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 573.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 371.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 492.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 559.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 553.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 515.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 432.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 553.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 439.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 411.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 591.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 411.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 573.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 506.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 371.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 439.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 439.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 442.13
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 559.58
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 184.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 432.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 515.7
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 675,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 573.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 492.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 442.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 553.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 553.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 411.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 411.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 411.75
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 573.75
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 515.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 411.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 411.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 442.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 515.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 411.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 411.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 492.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 432.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 432.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 573.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 374.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 431.33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 675,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 371.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 492.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 442.13
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 594
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 573.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 515.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 553.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 553.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 675,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 675,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 432.68
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 675,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 506.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 439.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 432.68
            }
          ]
        }
      ]
    },
    {
      "description": "GUIDEWIRE 3.1 X 400MM TROCAR-TIPPED DISP DYNANAIL",
      "code_information": [
        {
          "code": "SUP-2200-18-4031",
          "type": "CDM"
        },
        {
          "code": "C1769",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 324,
          "discounted_cash": 210.6,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 247.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 247.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 204.77
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 210.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 284.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 204.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 204.77
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 210.92
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 275.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 243
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 275.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 204.77
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 275.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 247.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 208.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 284.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 179.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 265.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 208.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 208.01
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 275.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 236.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 265.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 204.77
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 243
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 236.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 236.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 265.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 262.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 265.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 208.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 247.54
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 275.4
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 275.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 208.01
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 275.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 243
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 210.92
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 285.12
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 178.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 179.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 210.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 204.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 247.54
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 236.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 265.68
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 179.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 265.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 178.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 178.2
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 324,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 208.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 236.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 265.68
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 268.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 275.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 247.54
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 275.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 208.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 208.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 208.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 178.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 179.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 262.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 208.01
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 275.4
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 88.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 275.4
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 236.52
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 268.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 210.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 275.4
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 213.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 268.6
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 204.77
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 265.68
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 208.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 178.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 210.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 178.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 208.01
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 324,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 204.77
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 275.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 324
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 324,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 275.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 178.2
            }
          ]
        }
      ]
    },
    {
      "description": "STAPLER 28MM EEA BLUE SINGLE USE",
      "code_information": [
        {
          "code": "SUP-EEA28",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2314.77,
          "discounted_cash": 1504.6,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1486.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1462.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1689.78
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1284.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1898.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1872.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2030.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1453.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1768.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1486.08
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1967.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1284.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1273.12
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1967.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1768.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1768.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1736.08
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1527.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1506.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1273.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1486.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1486.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1967.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1898.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1872.65
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1967.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1768.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1486.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1502.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1453.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1967.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1689.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1898.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1462.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1462.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1453.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1967.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1273.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1486.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1967.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1486.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1967.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1453.68
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1504.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1768.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1273.12
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1967.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1918.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1689.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1918.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1502.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1273.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1284.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1462.93
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 631.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1453.68
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1967.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1273.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1898.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1453.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1486.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1453.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2314.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1462.93
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1506.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1768.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1486.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1736.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1284.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1898.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1898.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1273.12
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1736.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1689.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1918.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1453.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1502.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1486.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1462.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1486.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1486.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1689.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1453.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 1502.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1462.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2030.05
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1967.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1453.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1462.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1453.68
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1898.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1506.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1898.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1453.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 1453.68
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1967.55
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1689.78
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2037
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1506.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1506.92
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2314.77,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "PENCIL 3/8IN X 10FT SMOKE EVAC NON-STICK ULTRA PLUMEPEN",
      "code_information": [
        {
          "code": "SUP-PLPUL2020",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 66,
          "discounted_cash": 42.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 53.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 53.39
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.45
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 54.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.71
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 42.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.71
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 54.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 42.83
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 36.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.71
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 49.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.3
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 42.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 54.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.37
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 66,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.97
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 18.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.42
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 49.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 57.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.71
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 58.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.37
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 49.5
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 43.56
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 36.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.97
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 57.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 36.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 36.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.45
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 56.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 42.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 48.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 54.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 42.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.45
            }
          ]
        }
      ]
    },
    {
      "description": "STAPLER 29MM POWERED INTRALUMINAL CVD",
      "code_information": [
        {
          "code": "SUP-CDH29P",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3354.63,
          "discounted_cash": 2180.51,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2153.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2106.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2120.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2448.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3354.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2153.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2562.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2448.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2153.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2851.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2120.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1845.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1861.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1861.82
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2851.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2120.13
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2851.44
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2214.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2120.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2180.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2120.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1845.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1845.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2713.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2177.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2183.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2106.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2177.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2562.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2177.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1845.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1861.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2750.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2515.97
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2952.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2183.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2713.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2120.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2448.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2750.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2106.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2942.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2562.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2851.44
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2515.97
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2851.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2106.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2750.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2106.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2106.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2183.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2153.67
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2515.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2780.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2750.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2106.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2750.8
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 915.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2120.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2562.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2153.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2448.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2153.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2562.94
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2851.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2750.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2106.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2106.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2851.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1845.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2153.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2106.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2942.01
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2851.44
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2851.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2448.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1861.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2183.86
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2851.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1845.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2106.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1845.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2153.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2153.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2120.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2562.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2153.67
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3354.63,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2448.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2106.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2183.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2153.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2780.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2750.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2851.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2851.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2153.67
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2780.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2750.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 2106.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 2177.15
            }
          ]
        }
      ]
    },
    {
      "description": "SLEEVE 12MM RADIALLY EXPANDABLE VERSASTEP DISP",
      "code_information": [
        {
          "code": "SUP-VS101000",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 117.6,
          "discounted_cash": 76.44,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 89.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 96.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 73.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 76.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 103.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 97.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 96.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 89.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 89.85
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.96
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 85.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 103.14
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 32.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 96.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 96.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 73.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 73.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 96.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 73.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 88.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 96.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 73.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 96.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 85.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 73.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 73.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.96
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 77.62
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 88.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 76.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.96
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 117.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 65.27
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 117.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 96.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 73.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 95.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 85.85
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 97.49
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 76.44
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 65.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 73.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 76.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 76.32
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 74.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 85.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 65.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 73.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 73.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 76.56
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.96
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 76.32
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 76.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 85.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 95.14
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 73.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 76.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 89.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 88.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 97.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 73.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 64.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 89.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 75.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 85.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 65.27
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 103.49
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 99.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 76.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 89.85
            }
          ]
        }
      ]
    },
    {
      "description": "FILLER 5CC BONE DRILLABLE INJECT NORIAN STERL",
      "code_information": [
        {
          "code": "SUP-07.704.005S",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3058.5,
          "discounted_cash": 1988.02,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1960.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1697.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2507.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1865.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1865.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2003.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2003.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1865.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2535.5
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1682.18
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1682.18
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1682.18
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1865.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2232.71
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2682.3
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2003.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2003.32
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1988.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1865.69
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1960.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2336.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2293.88
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2691.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2599.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1865.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1865.69
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2003.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2003.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1682.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2599.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1960.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1697.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2507.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1865.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2474.33
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2336.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1960.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3058.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2599.73
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2507.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2232.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2507.97
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2599.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1960.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2336.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2336.69
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2293.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1697.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2336.69
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2507.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2003.32
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 669.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1960.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1960.5
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2018.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2232.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1865.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1991.08
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2003.32
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2599.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1960.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1960.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1865.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1991.08
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2232.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2232.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1865.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1954.38
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1991.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2599.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2599.73
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2599.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1954.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2682.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1960.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2535.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1865.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1991.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1697.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1960.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2336.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2599.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2599.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1682.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1960.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2293.88
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2474.33
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2599.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1682.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2507.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1954.38
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2599.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1682.18
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3058.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2232.71
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2599.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2507.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1954.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1991.08
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 834.97
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2599.73
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2535.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2507.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1865.69
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 2.8 X 16MM NON-LOCK SOLID F/ PLATING SYSTEM OMNI",
      "code_information": [
        {
          "code": "SUP-144-28016",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 480,
          "discounted_cash": 312,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 366.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 420.96
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 264
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 292.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 366.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 393.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 314.4
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 480,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 306.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 420.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 307.68
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 480,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 408
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 307.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 366.72
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 292.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 312.48
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 408
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 408
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 350.4
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 312
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 314.4
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 408
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 307.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 306.72
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 306.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 292.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 366.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 408
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 480,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 360
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 408
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 316.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 408
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 292.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 292.8
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 408
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 350.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 397.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 388.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 264
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 480,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 408
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 408
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 266.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 312.48
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 397.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 393.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 292.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 312.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 314.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 264
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 307.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 307.68
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 480,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 306.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 350.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 266.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 266.4
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 480,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 480
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 307.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 360
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 314.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 408
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 393.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 408
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 264
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 393.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 266.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 292.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 312.48
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 131.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 314.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 388.32
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 307.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 360
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 264
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 393.6
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 292.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 350.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 314.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 307.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 366.72
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 350.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 366.72
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 422.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 264
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 397.92
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 292.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 314.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 480,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 393.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 393.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 393.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 292.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 292.8
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 408
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 264
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 307.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 307.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 307.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 408
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 350.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 292.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 312.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 314.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 307.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 292.8
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 3.5 X 36MM CANN COMP LAG F/ PLATING SYSTEM OMNI",
      "code_information": [
        {
          "code": "SUP-144-35236",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 612,
          "discounted_cash": 397.8,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 467.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 392.29
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 403.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 400.86
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 612,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 520.2
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 459
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 507.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 373.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 398.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 446.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 459
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 400.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 336.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 336.6
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 520.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 520.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 612
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 336.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 459
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 446.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 446.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 501.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 398.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 467.57
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 339.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 392.29
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 612,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 536.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 373.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 400.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 392.29
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 398.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 507.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 391.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 495.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 400.86
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 520.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 612,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 339.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 373.32
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 400.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 400.86
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 520.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 501.84
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 538.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 392.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 392.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 339.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 336.6
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 612,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 520.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 536.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 446.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 373.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 373.32
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 520.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 400.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 392.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 398.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 339.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 501.84
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 398.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 520.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 467.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 391.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 373.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 392.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 467.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 392.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 446.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 373.32
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 167.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 391.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 495.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 373.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 520.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 467.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 373.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 400.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 392.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 392.29
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 397.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 446.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 336.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 501.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 373.32
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 501.84
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 467.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 520.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 336.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 392.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 373.32
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 520.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 392.29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 520.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 520.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 336.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 501.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 501.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 501.84
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 612,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 612,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 612,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 507.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 391.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 373.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 373.32
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 520.2
            }
          ]
        }
      ]
    },
    {
      "description": "TRAP TISSUE F/ FLUENT FLUID MANAGEMENT",
      "code_information": [
        {
          "code": "SUP-FLT-010",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 30.9,
          "discounted_cash": 20.08,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.12
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.27
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.12
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 27.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.12
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 20.39
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 27.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 20.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 27.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.41
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 30.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 20.05
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 20.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.53
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 30.9
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.27
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 20.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 19.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 22.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 20.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 25.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 23.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 25.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 19.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 17.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 20.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.27
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 26.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 19.41
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 23.18
            }
          ]
        }
      ]
    },
    {
      "description": "AUGMENT 12MM SZ2.5 RT FEM DIST PFC SIGMA",
      "code_information": [
        {
          "code": "SUP-960850",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2712.15,
          "discounted_cash": 1762.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1738.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1733.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2194.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1491.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1776.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2223.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1738.49
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2034.11
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2712.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1738.49
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2305.33
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1491.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2072.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1738.49
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2305.33
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1654.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1765.61
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2305.33
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2072.08
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1979.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2223.96
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2248.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1733.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1765.61
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1776.46
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 593.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1733.06
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1790.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1738.49
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2305.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1738.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2223.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1654.41
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1491.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1491.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1738.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1738.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1979.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1979.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2248.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2305.33
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1765.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1738.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2305.33
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2034.11
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2386.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2072.08
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2223.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2223.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1654.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1654.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2223.96
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2305.33
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 740.42
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2248.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2223.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1776.46
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1491.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1654.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1654.41
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2305.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1733.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2378.56
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2305.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1654.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1654.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1654.41
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2305.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1491.68
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2072.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2072.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1738.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1776.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1654.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1765.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2072.08
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2305.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1738.49
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1654.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2223.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1762.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1776.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1979.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1505.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2194.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1738.49
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2378.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1776.46
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2305.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1491.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1979.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1505.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1505.24
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2034.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2305.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1979.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1505.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1654.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1654.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1765.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1776.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1776.46
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2305.33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2712.15,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "GUIDEWIRE .045IN W/ TROCAR TIP AND LASER LINE",
      "code_information": [
        {
          "code": "SUP-AR873704",
          "type": "CDM"
        },
        {
          "code": "C1769",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 47.25,
          "discounted_cash": 30.71,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 39.17
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 30.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.33
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 26.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 26.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 39.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.33
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.99
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 38.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 47.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.33
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.86
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 41.58
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.86
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 39.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 38.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 41.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.99
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.33
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 12.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 29.86
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 35.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 40.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 25.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.33
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 31.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 35.44
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 26.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 38.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 34.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 26.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 41.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 30.33
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 35.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 36.1
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 30.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 47.25,
              "additional_payer_notes": "OUTPATIENT"
            }
          ]
        }
      ]
    },
    {
      "description": "GUIDEWIRE 1.6 X 150MM NON-THRD SPADE PT ON ONE END",
      "code_information": [
        {
          "code": "SUP-292.727",
          "type": "CDM"
        },
        {
          "code": "C1769",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 64.5,
          "discounted_cash": 41.92,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 56.57
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.89
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 56.76
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 42.57
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.89
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.47
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.89
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 52.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.28
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.76
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 64.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.48
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 41.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.09
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 52.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 56.57
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.61
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.76
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.09
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.48
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.41
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 64.5,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            }
          ]
        }
      ]
    },
    {
      "description": "GUIDEWIRE 2.8 X 300MM W/FLUTES 150MM CALIBRATION",
      "code_information": [
        {
          "code": "SUP-292.81",
          "type": "CDM"
        },
        {
          "code": "C1769",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 231,
          "discounted_cash": 150.15,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 176.48
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 150.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 231
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 168.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 150.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 148.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 168.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 173.25
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 63.06
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 191.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 127.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 148.3
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 168.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 168.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 189.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 189.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 196.35
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 152.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 173.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 176.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 176.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 127.05
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 196.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 127.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 186.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 196.35
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 127.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 168.63
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 148.3
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 176.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 202.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 148.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 148.3
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 196.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 189.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 189.42
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 231,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 127.05
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 196.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 150.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 186.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 176.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 148.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 189.42
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 128.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 150.38
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 150.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 127.05
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 196.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 148.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 148.3
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 196.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 150.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 203.28
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 196.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 189.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 196.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 148.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 189.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 168.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 128.21
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 191.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 148.3
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 196.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 128.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 128.21
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 196.35
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 196.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 176.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 127.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 148.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 189.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 231,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 148.3
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 196.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 145.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 202.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 196.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 191.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 231,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 173.25
            }
          ]
        }
      ]
    },
    {
      "description": "HEAD 28MM 0 FEM COCR 12/14 00-8018-028-02",
      "code_information": [
        {
          "code": "SUP-00-8018-028-02",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1425.9,
          "discounted_cash": 926.83,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 914
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1169.24
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1212.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 911.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 869.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 869.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 869.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 928.26
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1069.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 784.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1069.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 914
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1089.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 869.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 869.8
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1212.02
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 914
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1040.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 928.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 784.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1212.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 933.96
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1040.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1040.91
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 312.27
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1212.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 914
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 914
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 933.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 911.15
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 933.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 791.37
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 914
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1069.43
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1212.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1182.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 914
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 869.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 933.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 933.96
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1182.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 869.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 928.26
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 926.84
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1212.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 914
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1212.02
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 869.8
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1040.91
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1182.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1169.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1169.24
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1254.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 784.25
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 784.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1089.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1089.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 928.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 869.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1212.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 914
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 914
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 933.96
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1169.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1169.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 933.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1425.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1212.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 784.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1250.51
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 941.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 791.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 911.15
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1212.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1089.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1212.02
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1040.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1169.24
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1212.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1089.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 784.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1169.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 869.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1089.39
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 784.25
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 389.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 914
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 911.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 914
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 869.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1153.55
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 791.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1250.51
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1212.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1040.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1169.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 869.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 928.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 933.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 791.37
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1425.9,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1212.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1153.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 869.8
            }
          ]
        }
      ]
    },
    {
      "description": "HEMOSTAT 3GM ARISTA",
      "code_information": [
        {
          "code": "SUP-SM0002-USA",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 495,
          "discounted_cash": 321.75,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 317.79
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 321.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 420.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 420.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 272.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 312.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 378.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 400.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 272.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 312.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 405.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 321.26
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 135.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 312.84
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 420.75
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 420.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 322.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 274.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 272.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 272.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 310.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 317.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 378.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 317.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 272.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 420.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 310.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 322.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 405.9
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 410.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 310.86
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 420.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 272.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 405.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 322.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 420.75
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 371.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 272.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 310.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 310.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 317.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 378.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 317.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 361.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 274.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 495
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 312.84
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 495,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 405.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 361.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 361.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 321.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 322.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 312.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 434.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 312.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 378.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 317.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 420.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 310.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 310.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 317.79
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 371.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 420.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 317.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 378.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 312.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 378.18
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 435.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 361.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 322.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 312.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 317.79
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 326.7
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 420.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 420.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 410.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 405.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 310.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 310.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 310.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 317.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 405.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 317.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 371.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 420.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 361.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 274.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 405.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 405.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 310.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 321.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 317.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 361.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 434.12
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 274.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 310.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 400.46
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 410.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 321.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 310.86
            }
          ]
        }
      ]
    },
    {
      "description": "STEM 14MM TIB SMOOTH TOP RT AND LT INBONE",
      "code_information": [
        {
          "code": "SUP-200012901",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1464,
          "discounted_cash": 951.6,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 938.42
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 958.92
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1244.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1068.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 812.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 893.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1184.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 938.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1118.5
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 966.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 893.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 893.04
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 938.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 893.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 953.06
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1098
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 958.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 958.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1213.66
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1244.4
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1288.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1244.4
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1213.66
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 399.67
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1068.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 958.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1200.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 893.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 938.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 938.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 938.42
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1244.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1244.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1244.4
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 953.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 805.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 812.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1200.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1200.48
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1283.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1244.4
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 958.92
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 951.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 958.92
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1244.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1184.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 805.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 893.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 893.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 958.92
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1244.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 805.2
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1068.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 812.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1118.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1200.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 935.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 953.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 953.06
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1118.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 893.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 953.06
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1244.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 893.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 805.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1200.48
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 805.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 805.2
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1244.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 938.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1213.66
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1098
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 893.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 893.04
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1118.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1068.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 935.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 893.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1200.48
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 320.62
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1244.4
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1244.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1118.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 812.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 938.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 938.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1200.48
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 958.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 805.2
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1244.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1118.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 938.42
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1068.72
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1200.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 935.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 935.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 893.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 938.42
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1098
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1068.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1464
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1283.93
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1464,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 938.42
            }
          ]
        }
      ]
    },
    {
      "description": "GRAFT 10CC BONE SUB REGENERATIVE INJECTABLE PRO-DENSE",
      "code_information": [
        {
          "code": "SUP-87SR-0100",
          "type": "CDM"
        },
        {
          "code": "C1734",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7950,
          "discounted_cash": 5167.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5095.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5080.05
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4412.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5175.45
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5247
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6519
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5175.45
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4372.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4372.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6073.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5803.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5803.5
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2170.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6431.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5207.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5095.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5095.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5962.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4412.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4849.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5803.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5095.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5095.95
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6996
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7950,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5962.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6972.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5207.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7950,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5095.95
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5803.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5167.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5095.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4372.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4412.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6519
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1741.05
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5962.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5175.45
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5803.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4849.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4849.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5175.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5207.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6590.55
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6519
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3034.98,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4849.5
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1431
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6073.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5080.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4412.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6519
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5207.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5207.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6073.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6073.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6590.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4849.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5207.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6519
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4849.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5095.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6073.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4372.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5803.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7950
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4849.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5095.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5207.25
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4849.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6519
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5080.05
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1431
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4372.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6073.8
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 5207.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5095.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5095.95
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4372.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4849.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4849.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6972.15
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6519
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6519
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4849.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4849.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4849.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 5080.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 5095.95
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2890.46,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7950,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6590.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5175.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4372.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6431.55
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6757.5
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 3.5 X 32MM LAG THRD CROSSCHECK",
      "code_information": [
        {
          "code": "SUP-5820X3532",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 606,
          "discounted_cash": 393.9,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 388.45
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 399.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 336.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 496.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 369.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 369.66
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 454.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 388.45
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 502.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 369.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 394.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 515.1
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 515.1
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 606,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 394.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 531.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 396.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 496.92
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 394.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 333.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 515.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 515.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 333.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 388.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 369.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 496.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 387.23
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 393.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 388.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 388.45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 515.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 388.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 462.98
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 515.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 496.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 496.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 396.93
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 606,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 442.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 388.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 388.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 369.66
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 396.93
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 533.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 442.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 502.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 394.51
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 396.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 388.45
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 606,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 336.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 387.23
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 490.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 515.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 388.45
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 515.1
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 369.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 515.1
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 454.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 442.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 442.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 606
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 515.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 515.1
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 515.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 333.3
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 515.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 336.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 496.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 369.66
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 606,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 333.3
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 396.93
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 496.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 369.66
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 369.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 490.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 515.1
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 165.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 462.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 369.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 396.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 396.93
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 396.93
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 606,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 388.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 454.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 442.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 502.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 496.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 387.23
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 606,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 531.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 369.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 462.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 388.45
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 333.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 394.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 369.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 336.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 387.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 369.66
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 333.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 462.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 442.38
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 462.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 462.98
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 606,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 333.3
            }
          ]
        }
      ]
    },
    {
      "description": "SCREW 2 X 12MM SHORT CANN DARTFIRE EDGE",
      "code_information": [
        {
          "code": "SUP-D0120012",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 501,
          "discounted_cash": 325.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 321.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 375.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 328.16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 328.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 415.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 320.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 321.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 382.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 321.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 410.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 439.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 321.14
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 305.61
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 136.77
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 305.61
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 321.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 501
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 320.14
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 321.14
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 501,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 501,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 305.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 410.82
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 410.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 275.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 305.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 439.38
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.85
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 365.73
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 365.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 320.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 305.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.85
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 278.06
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 305.61
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 501,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.85
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.85
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 330.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 321.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 321.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 365.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 278.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 305.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 305.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 328.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 275.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 328.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 275.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 415.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 305.61
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 365.73
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 305.61
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 501,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 321.14
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 328.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 328.16
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 501,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 321.14
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 415.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 410.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 321.14
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 440.88
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 501,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 326.15
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 375.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 365.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 275.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 305.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 405.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 278.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 328.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 275.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 382.76
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 325.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 326.15
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 382.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 410.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 326.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 405.31
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 501,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 321.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 410.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 365.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 410.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 410.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 320.14
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 326.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 326.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 382.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 275.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 275.55
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 375.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 382.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 305.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 382.76
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 278.06
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 328.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 305.61
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.85
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 425.85
            }
          ]
        }
      ]
    },
    {
      "description": "TAP 6.5MM CANN LG AO FITTING ASNIS III",
      "code_information": [
        {
          "code": "SUP-702602",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1389.6,
          "discounted_cash": 903.24,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1061.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1042.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 878.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1139.47
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1042.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1061.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1014.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 771.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 892.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1014.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1218.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 878.23
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1181.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1218.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 892.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 878.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 771.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 872.67
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1042.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1124.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 764.28
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1181.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 872.67
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1181.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 878.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 764.28
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1181.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 872.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 892.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1181.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1139.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1139.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1139.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 904.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1181.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 764.28
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1389.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 892.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1151.98
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1181.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1014.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 892.12
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1139.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 904.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1014.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1139.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 872.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 904.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1139.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1124.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1061.65
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1222.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1014.41
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1151.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 892.12
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 917.14
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 901.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 901.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 878.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 892.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 892.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1061.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1151.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 872.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 878.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 771.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 872.67
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1181.16
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 379.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 901.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1061.65
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1181.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1389.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 764.28
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1181.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 892.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 872.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 904.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 892.12
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1181.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 872.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 872.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 872.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 771.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1139.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 904.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 878.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 878.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 764.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 764.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 764.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 892.12
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1181.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1061.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 892.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1014.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 901.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 872.67
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 903.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 872.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 872.67
            }
          ]
        }
      ]
    },
    {
      "description": "BIT 2 X 110MM DRILL CALIB 60MM NS QC FOR UNIV SM FRAG SYS",
      "code_information": [
        {
          "code": "SUP-03.133.101",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 459,
          "discounted_cash": 298.35,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 380.51
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 254.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 376.38
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 390.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 344.25
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 390.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 298.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 335.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 290.09
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 390.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 376.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 298.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 376.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 380.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 288.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 350.68
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 302.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 290.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 297.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 390.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 254.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 290.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 402.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 390.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 390.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 288.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 298.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 298.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 290.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 350.68
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 344.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 376.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 350.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 376.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 297.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 297.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 288.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.45
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 403.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 335.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 288.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 254.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.45
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 390.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 344.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 297.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 288.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 288.25
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 125.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 290.09
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 390.15
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 390.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 350.68
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 390.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 288.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 376.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 288.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 290.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 459
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 376.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 290.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 335.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 371.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 290.09
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 390.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 371.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 288.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 350.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 335.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 380.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 288.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 350.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 402.54
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 390.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 294.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 288.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 298.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 335.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 288.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 288.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 298.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 335.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 376.38
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 459,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 252.45
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 254.75
            }
          ]
        }
      ]
    },
    {
      "description": "BIT 2.5 X 240MM DRILL CALIB 150MM NS QC FOR UNIV SM FRAG SYS",
      "code_information": [
        {
          "code": "SUP-03.133.104",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 469.5,
          "discounted_cash": 305.17,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 301.42
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 384.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 294.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 294.85
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 294.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 358.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 342.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 301.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 301.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 358.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 301.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 469.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 260.57
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 260.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 384.99
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 352.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 301.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 296.72
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 352.13
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 389.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 305.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 258.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 384.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 305.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 358.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 296.72
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 294.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 304.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 301.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 260.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 384.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 384.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 301.42
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 128.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 258.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 304.71
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 413.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 301.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 258.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 294.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 258.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 301.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 358.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 342.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 294.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 294.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 294.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 296.72
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 342.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 296.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 296.72
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.08
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 258.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 384.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 294.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 305.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 301.42
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 260.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 305.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 379.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 384.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 296.72
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 411.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 258.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 304.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 305.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 342.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 258.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 294.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 294.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 411.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 342.74
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 469.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 301.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 389.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 384.99
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 309.87
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 305.18
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 294.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 296.72
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 352.13
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 389.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 304.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 358.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 358.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 301.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 379.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 296.72
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 399.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 342.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 294.85
            }
          ]
        }
      ]
    },
    {
      "description": "PLATE 3.5MM 14HL LCP CVD NARROW STERL",
      "code_information": [
        {
          "code": "SUP-02.161.214S",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1612.5,
          "discounted_cash": 1048.12,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1033.61
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1370.63
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 894.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1033.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1231.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1033.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1033.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1370.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1177.13
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1419
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1056.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1336.76
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 886.88
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1370.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1231.95
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1322.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1030.39
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1304.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1049.74
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1370.63
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 894.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1030.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1033.61
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1414.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 886.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 894.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1612.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1414.16
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1033.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 894.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1177.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1056.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 886.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 983.63
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1231.95
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 983.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 983.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1030.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1336.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1322.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1370.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1056.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1033.61
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1370.63
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1336.76
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1370.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1177.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1322.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 886.88
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1209.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1033.61
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1322.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1322.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1322.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1056.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1056.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1231.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1177.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 983.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1030.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 983.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 983.63
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1177.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1322.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1370.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1033.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1033.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1231.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1209.38
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1056.19
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 983.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1370.63
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1209.38
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1064.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 886.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 886.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 886.88
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 983.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1049.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 983.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1049.74
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1048.13
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 353.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1033.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 983.63
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1049.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1370.63
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1370.63
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1370.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 983.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1033.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 983.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1177.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1322.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1049.74
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 440.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1231.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1056.19
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1370.63
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 983.63
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1370.63
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1612.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1304.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1056.19
            }
          ]
        }
      ]
    },
    {
      "description": "GUIDEWIRE 1.4 X 150MM TROCAR TIP F/ CANN COMP HDLSS SCREW",
      "code_information": [
        {
          "code": "SUP-03.333.002",
          "type": "CDM"
        },
        {
          "code": "C1769",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 221.01,
          "discounted_cash": 143.66,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 141.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 139.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 183.22
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 187.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 187.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 168.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 168.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 165.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 141.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 193.83
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 187.86
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 187.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 161.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 181.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 143.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 178.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 181.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 181.23
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 194.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 187.86
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 139.68
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 165.76
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 141.89
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 145.87
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 168.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 181.23
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 161.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 187.86
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 121.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 139.68
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 141.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 121.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 122.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 187.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 161.34
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 121.56
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 187.86
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 181.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 178.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 168.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 168.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 187.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 161.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 161.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 181.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 143.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 139.68
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 60.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 141.89
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 121.56
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 121.56
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 187.86
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 187.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 143.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 141.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 168.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 141.89
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 141.89
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 139.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 139.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 121.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 161.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 122.66
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 187.86
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 165.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 143.88
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 181.23
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 122.66
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 183.22
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 183.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 141.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 141.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 193.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 141.89
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 139.68
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 121.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 181.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 141.89
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 187.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 143.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 139.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 221.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 143.66
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 187.86
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 122.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by percent of billed.",
              "estimated_amount": 221.01,
              "additional_payer_notes": "OUTPATIENT EXCLUSIONS"
            }
          ]
        }
      ]
    },
    {
      "description": "BIT 2.8 X 170MM DRILL CALIB 80MM NS QC FOR UNIV SM FRAG SYS",
      "code_information": [
        {
          "code": "SUP-03.133.107",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 433.5,
          "discounted_cash": 281.77,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 238.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.31
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 282.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 380.18
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 282.21
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.48
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 433.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 282.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 350.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 331.19
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 281.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 316.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.48
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 238.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 281.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 238.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 238.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 240.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 281.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 433.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 359.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 331.19
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 316.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 316.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 316.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 282.21
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 325.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 331.19
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 240.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 282.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 238.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.24
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 240.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 331.19
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 286.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 325.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 238.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.97
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 278.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 316.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 331.19
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 316.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 368.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 273.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 281.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 331.19
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 118.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 380.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 359.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 359.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 350.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 281.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 325.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 238.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 240.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 355.47
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 381.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 272.24
            }
          ]
        }
      ]
    },
    {
      "description": "BIT 1.6 X 95MM DRILL CANN QC F/ CANN COMP HDLSS SCREW",
      "code_information": [
        {
          "code": "SUP-03.333.100",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1237.02,
          "discounted_cash": 804.06,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 794.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 794.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.36
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 927.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1014.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1084.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 781.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.47
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 337.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 794.17
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.47
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1014.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 776.85
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 804.06
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 903.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 903.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 686.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1025.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 794.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 776.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 802.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 781.8
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 945.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 945.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1014.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 805.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 794.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 903.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1014.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 802.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 776.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 802.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 776.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 776.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1000.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1237.02,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1084.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 945.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 927.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 903.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 802.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 686.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 805.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 781.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 794.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 776.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 781.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 781.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 794.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 945.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 805.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1014.36
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1014.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 794.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 903.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.36
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1088.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 794.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1014.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 805.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 945.08
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 816.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 686.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 776.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 776.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1014.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 794.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 794.17
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.47
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 781.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 781.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1237.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 776.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 776.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 776.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 927.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 686.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1025.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 781.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 945.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1025.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1000.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 776.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 805.3
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.47
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1051.47
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 903.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 776.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 680.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 794.17
            }
          ]
        }
      ]
    },
    {
      "description": "COMPONENT SZ4 RT FEM NARROW POST STABILIZED PERSONA",
      "code_information": [
        {
          "code": "SUP-42-5060-056-02",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 13965,
          "discounted_cash": 9077.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10669.26
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11870.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 9147.08
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 9147.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8951.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11451.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9091.22
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11870.25
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 12289.2
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7680.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 8923.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11451.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8518.65
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3812.45
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 9077.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10473.75
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7750.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7750.58
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10669.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8951.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10669.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10194.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8518.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8518.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8518.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9091.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7680.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11576.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11451.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8518.65
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8951.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8951.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10669.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8518.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11297.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8951.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 9147.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8951.57
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 9216.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9091.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9091.22
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11870.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11870.25
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11870.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10669.26
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10194.45
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10473.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8518.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10473.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10194.45
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8518.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 8923.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8518.65
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 2513.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 8923.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10194.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8951.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11870.25
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11870.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11451.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11451.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8518.65
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7680.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7680.75
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 12247.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 9147.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8951.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11576.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10669.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8951.57
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11870.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10194.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 9147.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 8923.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 9091.22
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 2513.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7680.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11870.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11576.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11451.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8518.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8951.57
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 10194.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 9147.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7750.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7750.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8518.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8518.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8951.57
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11870.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11870.25
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7680.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11451.3
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13965,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 9147.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 9147.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 12247.31
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11870.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11870.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11451.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8951.57
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 3058.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7680.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 11297.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11870.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 13965
            }
          ]
        }
      ]
    },
    {
      "description": "ARCH ALIGNMENT EXTRAMEDULLARY NEXGEN",
      "code_information": [
        {
          "code": "SUP-00-5977-024-00",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 499.8,
          "discounted_cash": 324.87,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 320.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 364.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 313.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 313.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 438.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 313.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 409.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 313.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 404.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 320.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 320.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 315.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 274.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 320.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 364.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 315.87
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 439.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 320.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 424.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 381.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 325.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 315.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 424.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 381.85
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 499.8,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 374.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 424.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 499.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 313.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 424.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 274.89
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 324.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 277.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 414.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 325.37
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 136.45
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 424.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 364.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 364.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 404.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 374.85
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 329.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 324.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 320.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 381.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 409.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 320.87
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 424.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 274.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 313.87
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 277.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 409.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 313.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 315.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 313.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 364.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 315.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 320.87
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 414.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 414.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 313.87
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 424.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 320.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 409.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 320.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 274.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 315.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 315.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 409.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 313.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 324.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 325.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 315.87
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 424.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 274.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 313.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 381.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 324.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 438.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 274.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 364.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 320.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 409.84
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 424.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 277.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 313.87
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 424.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 409.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 324.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 381.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 320.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 409.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 325.37
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 424.83
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 424.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 277.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 313.87
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 274.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 325.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 381.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 374.85
            }
          ]
        }
      ]
    },
    {
      "description": "CONNECTOR 3.5MM SHORT INSERTER",
      "code_information": [
        {
          "code": "SUP-14-441045",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1367.85,
          "discounted_cash": 889.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1045.04
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1162.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 759.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1121.64
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1162.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 895.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 759.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 834.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 890.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 876.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 876.79
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1045.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 876.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 834.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 874.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 876.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1133.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 834.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 834.39
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1025.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1162.67
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 890.47
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1162.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 876.79
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 902.78
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1162.67
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1162.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1045.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1162.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 998.53
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 373.42
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 998.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 998.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1133.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 834.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 834.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 895.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1199.6
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 752.32
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1367.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1121.64
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1121.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 874.06
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 876.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 998.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 834.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1106.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1121.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 890.47
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 752.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 752.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 895.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 895.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1199.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 876.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 895.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 834.39
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1045.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 998.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 834.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 834.39
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1162.67
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1203.71
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1162.67
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 834.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 752.32
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1162.67
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 895.94
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1025.89
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1106.59
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 876.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 876.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1162.67
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 998.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1162.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 890.47
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1121.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 876.79
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 874.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 759.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1121.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 890.47
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1133.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 759.16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 895.94
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1045.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1162.67
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1025.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1045.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 299.56
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1162.67
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 752.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 874.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 834.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1121.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1121.64
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 889.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 876.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 876.79
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 752.32
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1367.85,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 895.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 752.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 834.39
            }
          ]
        }
      ]
    },
    {
      "description": "KIT REPAIR DISTAL BICEPS IMPLANT",
      "code_information": [
        {
          "code": "SUP-AR-2260",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2677.5,
          "discounted_cash": 1740.37,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2045.61
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2195.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1753.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2348.17
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2356.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1716.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1743.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1716.28
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2195.55
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1767.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1753.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1633.28
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 730.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1753.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1472.63
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1472.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1954.58
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2677.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1486.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1743.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1753.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1472.63
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2275.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1633.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1743.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1716.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1716.28
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1954.58
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2348.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2195.55
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1710.92
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2275.88
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2275.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1716.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1716.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2045.61
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2275.88
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2275.88
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2275.88
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2275.88
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2275.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1954.58
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2275.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1472.63
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1486.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1633.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2219.65
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1954.58
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1486.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1633.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1633.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1633.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1716.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2045.61
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1633.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1753.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1472.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1633.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1710.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1633.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2219.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2195.55
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2275.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1716.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1716.28
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2008.13
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1740.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1753.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1753.76
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1954.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1954.58
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 586.37
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2275.88
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2045.61
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1710.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1743.05
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2275.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2045.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1716.28
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2275.88
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2008.13
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1743.05
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1486.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1472.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1633.28
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2166.1
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2195.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1633.28
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1472.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1716.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1716.28
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2195.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1710.92
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2008.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2219.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2195.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2166.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1753.76
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2045.61
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2677.5,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2275.88
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2195.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1633.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1633.28
            }
          ]
        }
      ]
    },
    {
      "description": "ADAPTER 0MM HEAD FEM UNIPOLAR",
      "code_information": [
        {
          "code": "SUP-4510-10-000",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 356.49,
          "discounted_cash": 231.72,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 272.36
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 303.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 217.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 272.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 292.32
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 303.02
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 303.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 233.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 292.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 232.07
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 97.32
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 231.72
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 196.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 196.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 196.07
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 303.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 260.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 292.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 227.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 217.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 312.64
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 313.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 233.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 303.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 267.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 260.24
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 196.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 217.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 197.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 217.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 272.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 272.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 217.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 217.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 267.37
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 303.02
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 303.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 260.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 303.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 295.53
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 260.24
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 232.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 233.5
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 303.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 260.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 197.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 227.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 288.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 295.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 292.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 217.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 196.07
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 233.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 303.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 292.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 217.46
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 232.07
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 235.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 233.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 292.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 232.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 233.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 197.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 217.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 217.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 227.8
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 303.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 292.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 233.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 312.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 196.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 196.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 217.46
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 303.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 260.24
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 267.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 288.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 217.46
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 295.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 217.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 272.36
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 227.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 233.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 197.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 356.49
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 303.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 228.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 272.36
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 356.49,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 303.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 292.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 232.07
            }
          ]
        }
      ]
    },
    {
      "description": "LINER 32 X 52 10DEG DUR MAR",
      "code_information": [
        {
          "code": "SUP-122032152",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4808.7,
          "discounted_cash": 3125.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3673.85
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1053.11
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4087.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2933.31
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3125.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2644.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3082.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3149.7
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 865.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2933.31
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3082.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4808.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3130.46
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1312.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 865.57
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2644.79
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4087.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3986.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3943.13
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4087.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3673.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4087.4
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4087.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3606.53
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2933.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2933.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2933.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4217.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3673.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3082.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4087.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3082.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3943.13
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3149.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2644.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2933.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3130.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3072.76
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4087.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3149.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3082.38
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3173.74
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3082.38
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3149.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3149.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3082.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4087.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3510.35
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2933.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2668.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3149.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3082.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3082.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3082.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3510.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3130.46
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4087.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2644.79
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2668.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3986.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2933.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3072.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2933.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3072.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3673.85
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2668.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3943.13
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4087.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3673.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4217.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3673.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2933.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3082.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3943.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2933.31
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4087.4
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3943.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2933.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3943.13
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3130.46
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3130.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3606.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3510.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 3082.38
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4087.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3890.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3510.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3890.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3149.7
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4231.66
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4087.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3510.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2668.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2933.31
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3606.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 3149.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3986.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3943.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3943.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 3072.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2644.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2644.79
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3510.35
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4087.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2644.79
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4808.7,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "MINIPLATE 12 X 20MM 2.5MM OFFSET TITAN NANOLOCK ANTERALIGN",
      "code_information": [
        {
          "code": "SUP-46841220",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10200,
          "discounted_cash": 6630,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6538.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6222
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 6681
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5661
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7650
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6517.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6222
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6640.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6538.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6538.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8670
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 6681
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7650
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7446
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 6681
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8976
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8670
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5661
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8364
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8251.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8670
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 6681
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6538.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8364
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6517.8
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8670
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5610
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6630
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6517.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7792.8
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8670
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1836
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5610
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6222
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8670
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6538.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8670
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 6681
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7792.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6538.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8670
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5610
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10200
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7446
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8364
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2784.6
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8670
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6640.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1836
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5610
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 6681
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7792.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6538.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8670
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8945.4
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8455.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6222
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6640.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8455.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8670
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6538.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6538.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7792.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7446
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5661
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5661
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 6681
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6222
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6222
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8251.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7792.8
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8670
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7650
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6538.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6640.2
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6732
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8364
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6538.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8670
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6222
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8364
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8364
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6222
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8945.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8670
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7446
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 6538.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7446
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 2233.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8364
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6222
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6222
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6222
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6222
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6640.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 6517.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 6681
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5610
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7792.8
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 6222
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7446
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8455.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5610
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5610
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8364
            }
          ]
        }
      ]
    },
    {
      "description": "ADAPTER STD TAPER VERSA-DIAL/COMP",
      "code_information": [
        {
          "code": "SUP-118001",
          "type": "CDM"
        },
        {
          "code": "C1776",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 450,
          "discounted_cash": 292.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 288.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 288.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 343.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 249.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 369
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 274.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 369
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 288.45
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 369
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 287.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 274.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 328.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 287.55
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 294.75
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 328.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 373.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 369
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 249.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 274.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 274.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 294.75
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 382.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 288.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 247.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 247.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 274.5
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 450,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 382.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 288.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 394.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 249.75
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 343.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 247.5
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 337.5
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 297
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 382.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 247.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 292.95
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 382.5
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 337.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 369
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 274.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 294.75
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 396
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 450,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 328.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 450
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 288.45
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 328.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 249.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 369
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 288.45
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 382.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 382.5
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 382.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 274.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 292.95
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 337.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 288.45
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 382.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 288.45
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 382.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 373.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 287.55
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 274.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 364.05
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 450,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 369
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 450,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 247.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 382.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 247.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 343.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 382.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 274.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 364.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 294.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 343.8
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 122.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 294.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 274.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 394.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 288.45
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 369
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 274.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 292.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 294.75
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 450,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 382.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 343.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 328.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 450,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 328.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 294.75
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 450,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 274.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 292.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 288.45
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 382.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 373.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 292.95
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 292.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 343.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 288.45
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 294.75
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 382.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 274.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 247.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 287.55
            }
          ]
        }
      ]
    },
    {
      "description": "SIZER 210CC BREAST GEL MOD PRO SMOOTH ROUND HSC PLUS",
      "code_information": [
        {
          "code": "SUP-GS10512-210MP",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 600,
          "discounted_cash": 390,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 458.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 396
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 330
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 458.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 526.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 600,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 492
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 485.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 330
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 163.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 330
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 458.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 438
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 390.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 389.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 390
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 389.4
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 438
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 497.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 379.2
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 528
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 379.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 379.2
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 390.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 333
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 389.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 390.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 330
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 526.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 492
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 390.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 450
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 438
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 458.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 497.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 492
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 485.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 492
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 379.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 379.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 497.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 438
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 492
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 438
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 330
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 330
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 333
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 492
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 379.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 330
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 450
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 379.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 438
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 458.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 492
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 492
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 333
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 390.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 458.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 450
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 600
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 389.4
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 510
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 333
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 376.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 385.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 379.2
            }
          ]
        }
      ]
    },
    {
      "description": "STENT 10 X 30MM 8FR 900MM TRACH/BRONCH SILICONE BONASTENT",
      "code_information": [
        {
          "code": "SUP-BTB-100309",
          "type": "CDM"
        },
        {
          "code": "C1874",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 7485,
          "discounted_cash": 4865.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4797.89
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4116.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4116.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6205.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4872.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4797.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5718.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4797.89
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5464.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6137.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4565.85
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6362.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4902.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6564.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4902.68
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4902.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6055.37
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4116.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6205.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4902.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4116.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4797.89
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6362.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5613.75
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4565.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6362.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6137.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6137.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4565.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4782.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4565.85
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6362.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4797.89
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6362.25
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4902.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4797.89
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4902.68
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1347.3
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6205.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6055.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 6564.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5464.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5464.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4565.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4872.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4154.18
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6362.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6137.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4565.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4565.85
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5464.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4797.89
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1639.22
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4865.25
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6362.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5718.54
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6362.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4116.75
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5718.54
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5464.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4154.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6137.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6137.7
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4782.92
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6362.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 7485
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4797.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4797.89
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5613.75
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4116.75
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4565.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4872.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5718.54
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5718.54
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 5613.75
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6362.25
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6362.25
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4565.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4565.85
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 5464.05
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4782.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4565.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4872.74
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4940.1
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4154.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6137.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4565.85
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 6586.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1347.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6137.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4782.92
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4797.89
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4872.74
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6362.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6362.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4116.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4797.89
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4797.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4154.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4902.68
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 6362.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5718.54
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2043.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4902.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 4565.85
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 7485,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "MESH 10 X 15CM GYNE PROLENE SOFT",
      "code_information": [
        {
          "code": "SUP-GPSL",
          "type": "CDM"
        },
        {
          "code": "C1781",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1492.08,
          "discounted_cash": 969.85,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1139.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 910.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 910.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 820.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 910.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 971.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1207.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 956.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 956.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 956.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1223.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1223.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 953.44
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 956.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 956.42
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1223.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 820.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1089.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 828.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 910.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 910.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1089.22
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1268.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 977.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 956.42
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1268.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 910.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 971.34
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 326.77
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1268.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 956.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 910.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 977.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 977.31
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 956.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1223.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 910.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 953.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 910.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1139.95
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 953.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1268.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 820.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 820.64
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1268.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 820.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 820.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 971.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 971.34
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1308.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 977.31
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1268.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 956.42
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1119.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 828.1
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1236.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1223.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 910.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1268.27
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1139.95
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 984.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 977.31
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1268.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 910.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 977.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1492.08
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1268.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1089.22
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1268.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 820.64
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1089.22
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1139.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 828.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 969.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 407.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1119.06
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 828.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 910.17
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1268.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 977.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1308.55
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 956.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1223.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 953.44
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1089.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1089.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 977.31
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1119.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1223.51
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1236.93
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1236.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 910.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 971.34
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1268.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 956.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1139.95
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1268.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 956.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1139.95
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1492.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1268.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1207.09
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1313.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1223.51
            }
          ]
        }
      ]
    },
    {
      "description": "SUTURE 7-0 30IN PROLENE EPM8751 BV175-8 BLUE",
      "code_information": [
        {
          "code": "SUP-EPM8751",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 274.82,
          "discounted_cash": 178.63,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 209.96
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 206.12
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 181.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 200.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 178.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 200.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 225.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 225.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 225.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 200.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 152.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 172.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 173.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 200.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 178.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 178.91
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 172.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 178.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 200.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 173.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 225.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 225.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 172.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 178.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 222.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 173.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.6
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 227.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 172.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 173.69
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 206.12
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 274.82,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 75.03
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 152.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 209.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 209.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 209.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 225.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 172.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 241.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 227.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 225.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 172.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 225.35
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 178.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 173.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 178.36
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.43
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 173.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 274.82
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 241.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 172.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 172.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 172.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 178.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 178.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 209.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 172.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.43
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 222.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 173.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 241.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 152.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 178.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 172.59
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.6
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 206.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.43
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 172.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 176.43
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 227.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.6
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 233.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 209.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 152.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 173.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 200.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 172.59
            }
          ]
        }
      ]
    },
    {
      "description": "MESH 5.4 X 7IN LG OVAL W/PTFE VENTRIO",
      "code_information": [
        {
          "code": "SUP-0010212",
          "type": "CDM"
        },
        {
          "code": "C1781",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 3288,
          "discounted_cash": 2137.2,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2107.61
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2005.68
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1808.4
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1808.4
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2696.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2659.99
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2794.8
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2794.8
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2794.8
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2794.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2005.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2794.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2400.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2400.24
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2794.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2466
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2153.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2153.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2696.16
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 720.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2101.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1824.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2696.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2512.03
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2005.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2005.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2005.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2005.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2107.61
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2170.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2107.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2107.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2107.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2107.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2140.49
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2107.61
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2794.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2512.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2794.8
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2794.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2400.24
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2794.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1808.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2153.64
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2725.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2005.68
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2140.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2794.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2153.64
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2794.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2153.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2101.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2101.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2512.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2696.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2140.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2140.49
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2794.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1808.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2696.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2005.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2725.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2696.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2005.68
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2101.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2140.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2107.61
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2466
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 3288
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2005.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2512.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2400.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1808.4
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 2466
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2005.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2400.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2107.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1808.4
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2893.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1808.4
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1824.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2107.61
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2512.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 2512.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2883.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2153.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1824.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2153.64
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2137.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2107.61
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2696.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2005.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2005.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 2725.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 2696.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 2659.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2883.58
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2794.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2107.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1824.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 2400.24
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 897.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2153.64
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 3288,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "MESH 6 X 10IN OVAL ECHO VENTRALIGHT ST",
      "code_information": [
        {
          "code": "SUP-5955610",
          "type": "CDM"
        },
        {
          "code": "C1781",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4200,
          "discounted_cash": 2730,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2692.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2751
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2562
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2310
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3208.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3208.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3208.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2310
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2692.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3444
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3444
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3444
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2562
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2734.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3066
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2331
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2734.2
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2734.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3570
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3570
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2310
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2562
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2562
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2692.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2692.2
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2331
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2683.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3066
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2562
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3570
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3570
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2692.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3066
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4200
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2562
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3150
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3397.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3066
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2692.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2683.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3570
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2751
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2692.2
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2310
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2562
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2562
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2692.2
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3570
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3066
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2751
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3570
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3208.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3570
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3570
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3481.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3444
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2562
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2734.2
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2751
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3570
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2751
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2751
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3683.4
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3397.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2692.2
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3570
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 3696
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3444
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3683.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3444
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2692.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3066
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2562
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2734.2
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3208.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2310
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2692.2
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2772
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3150
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2562
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2683.8
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2331
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2310
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3150
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1146.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2331
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3208.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3444
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3481.8
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 919.8
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3570
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3481.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2562
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 2692.2
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3570
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3444
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 2562
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2751
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3570
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 2751
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 2730
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4200,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2310
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 2683.8
            }
          ]
        }
      ]
    },
    {
      "description": "PUTTY 5CC HEMOSTATIC SETTABLE RESORBABLE MONTAGE",
      "code_information": [
        {
          "code": "SUP-OS-MON-1001",
          "type": "CDM"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5547,
          "discounted_cash": 3605.55,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3561.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4237.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4049.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3600
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3483.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3611.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3483.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3483.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3561.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3561.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4049.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4049.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3483.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3611.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4714.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3611.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4237.91
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3078.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3483.52
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4714.95
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4714.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3505.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3483.52
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4049.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4237.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4237.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4487.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3505.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3050.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3050.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3561.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4598.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4548.54
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4548.54
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1514.33
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3605.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4864.72
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4714.95
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4598.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4548.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3600
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3561.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4714.95
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4714.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4548.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3611.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3050.85
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4160.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3561.17
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3661.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5547
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3483.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3561.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3050.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4160.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3078.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3483.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3483.52
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3505.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4714.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4237.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3561.17
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4714.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3078.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4548.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3600
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3483.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4548.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3050.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3561.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3561.17
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4160.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4487.52
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3611.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3505.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4049.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4049.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3505.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3505.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3600
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3483.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4548.54
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4864.72
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3561.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4237.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3505.7
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4881.36
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4714.95
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4714.95
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5547,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3483.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3483.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3050.85
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3078.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4548.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3050.85
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4714.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3561.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4598.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3505.7
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4714.95
            }
          ]
        }
      ]
    },
    {
      "description": "BALLOON 2 X 14CM ENDOCAVITY ULTRASOUND ADJUST INFLATE",
      "code_information": [
        {
          "code": "SUP-10833",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 114,
          "discounted_cash": 74.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.19
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 94.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 93.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 83.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 92.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 99.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 62.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 87.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.19
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 74.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 83.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 72.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 72.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 93.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 72.05
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 63.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 92.23
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 73.99
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 62.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 63.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 73.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 87.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 87.1
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 100.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 62.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 114
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 74.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 93.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.19
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 31.12
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 85.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 83.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 72.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.9
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 85.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 87.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 62.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 63.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 94.51
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 72.05
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 93.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.19
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 75.24
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 62.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 74.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 63.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 83.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 87.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 87.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 74.21
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 114,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 93.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 93.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 62.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 74.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 73.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 72.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 62.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 72.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 94.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.9
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 83.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 73.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 93.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 74.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 72.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 73.19
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 85.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 93.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 83.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 99.98
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 96.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 71.59
            }
          ]
        }
      ]
    },
    {
      "description": "PROBE 1.7MM X 7CM SHORT RT ANG ROUND ICE CRYOCARE SL",
      "code_information": [
        {
          "code": "SUP-11175",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5670,
          "discounted_cash": 3685.5,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4331.88
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4819.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3146.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4649.4
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3146.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4139.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3118.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3583.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3583.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3679.83
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4700.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4649.4
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 3685.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4819.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4649.4
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4649.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3560.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4331.88
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3742.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3583.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4139.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3679.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4587.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3118.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3560.76
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4819.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4649.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3560.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4972.59
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 4989.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3118.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3560.76
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4819.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4700.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3560.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4331.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4819.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3560.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3691.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3691.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4331.88
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4819.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3560.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3691.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3118.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 4972.59
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4139.1
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5670,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3691.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4819.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4819.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3583.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3146.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3691.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4252.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4139.1
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3146.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4331.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3118.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3560.76
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1547.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3583.44
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4819.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3560.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3679.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4649.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3560.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4819.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4252.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4139.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4139.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4331.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3560.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4819.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3640.14
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4819.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3583.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4700.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3560.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 3560.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4587.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3118.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5670
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3583.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4649.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 3679.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3583.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3118.5
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4252.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4649.4
            }
          ]
        }
      ]
    },
    {
      "description": "SUTURE 0 60IN PDS PLUS PDP9910G TP-1",
      "code_information": [
        {
          "code": "SUP-PDP9910G",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 15.74,
          "discounted_cash": 10.23,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.95
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 10.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12.73
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.38
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.81
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 10.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.95
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 13.8
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 15.74,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 11.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.88
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 10.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.95
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 10.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 10.22
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.38
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.88
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.49
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 15.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 12.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.88
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.38
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.03
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.88
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.88
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 9.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 9.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 8.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 13.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 8.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10.11
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 10.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 13.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 11.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 12.91
            }
          ]
        }
      ]
    },
    {
      "description": "SUTURE 1 18IN STRATAFIX SPIRAL PDS PLUS SXPP2B203 OS-8",
      "code_information": [
        {
          "code": "SUP-SXPP2B203",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 60.41,
          "discounted_cash": 39.27,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 46.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 37.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 48.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.23
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 16.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 37.94
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 37.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.1
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 50.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 37.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 52.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 46.15
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 53.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 37.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 46.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 37.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 46.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 45.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 60.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 37.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 37.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 52.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 39.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 37.94
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.1
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 60.41,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.54
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 39.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 39.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 37.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 46.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 37.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 37.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.54
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 50.08
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 45.31
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 39.87
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 45.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 38.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.23
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 39.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 37.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 39.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 33.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.54
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 48.87
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 44.1
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 51.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 46.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 50.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 49.54
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 39.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 38.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 33.23
            }
          ]
        }
      ]
    },
    {
      "description": "SUTURE 3-0 12IN STRATAFIX SPIRAL MONOCRYL SXMP2B410 PS-1",
      "code_information": [
        {
          "code": "SUP-SXMP2B410",
          "type": "CDM"
        },
        {
          "code": "27200232",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 65.47,
          "discounted_cash": 42.56,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.62
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.12
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 49.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.79
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 52.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.01
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 65.47,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 49.1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.65
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 42.49
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 54.27
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 42.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 54.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 43.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.12
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 42.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 57.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 52.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.12
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 42.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.9,
              "estimated_amount": 42.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 50.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 54.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.12
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 57.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.01
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.65
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 36.01
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 49.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 62.8,
              "estimated_amount": 41.12
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 41.38
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.69
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 57.61
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 42.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 65.47
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 36.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 47.79
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 55.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 42.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 53.69
            }
          ]
        }
      ]
    },
    {
      "description": "CAGE 10-16 X 8 X 28MM 0DEG PARALLEL EXPANDABLE PROLIFT",
      "code_information": [
        {
          "code": "SUP-58-0828-1016",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 13500,
          "discounted_cash": 8775,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10314
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8653.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 8842.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11191.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8788.5
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11475
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11475
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8653.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8653.5
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11475
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10314
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8235
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8235
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10125
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7425
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 13500
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11070
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8235
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8235
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7492.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11475
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7425
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9855
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 8842.5
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11070
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 8842.5
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 11880
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9855
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7492.5
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7492.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11070
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 8626.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8235
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10314
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7425
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8235
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 11839.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9855
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11475
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8653.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10314
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9855
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 8626.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8235
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11191.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11070
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8235
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7425
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7425
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 3685.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8788.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9855
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11475
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8235
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 8842.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8653.5
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11475
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11070
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8788.5
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 8775
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8653.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8653.5
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 8910
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 8842.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8235
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 2430
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 2430
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 8842.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7425
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10314
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8235
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11475
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10125
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 8842.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 11839.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 10314
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11475
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 7425
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11070
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10921.5
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 2956.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11475
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 7492.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8653.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11070
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 10921.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8788.5
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11475
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 11191.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8235
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 8842.5
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11475
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 8235
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 8788.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 11070
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 13500,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11475
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8653.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 11475
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 10125
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8653.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8653.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 9855
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 8626.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 8626.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 8653.5
            }
          ]
        }
      ]
    },
    {
      "description": "NAIL11 X 340MM 10DEG BEND RETROGRADE RFN-ADVANCED",
      "code_information": [
        {
          "code": "SUP-04.233.135S",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6318.48,
          "discounted_cash": 4107.01,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4050.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4827.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4138.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5541.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5181.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3854.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3475.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5238.02
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4170.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5181.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4037.51
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4050.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5370.71
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4738.86
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1724.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4050.15
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5370.71
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4138.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5181.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4138.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1137.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4050.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4050.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3854.27
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5541.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3475.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6318.48
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5370.71
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4612.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4612.49
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5370.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4138.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4037.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4138.6
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5370.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3854.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3854.27
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4138.6
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4612.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4050.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4050.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4612.49
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5238.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5181.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3854.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4113.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4113.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4050.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3506.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3854.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3854.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4827.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5181.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4612.49
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4612.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3506.76
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4138.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3475.16
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 1383.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4827.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5370.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3854.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5111.65
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 4138.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5370.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4037.51
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3506.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4113.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3506.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3854.27
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5370.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5181.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3854.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3475.16
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5370.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4050.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4827.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4827.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3475.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5238.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4050.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5181.15
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 4107.01
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4738.86
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3475.16
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4050.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4827.32
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5370.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 4037.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 4050.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4738.86
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3854.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3854.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5111.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4113.33
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 18,
              "estimated_amount": 1137.33
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5370.71
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5181.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 3854.27
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5370.71
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6318.48,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5370.71
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5370.71
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5560.26
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3475.16
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4113.33
            }
          ]
        }
      ]
    },
    {
      "description": "ANCHOR HYBRID KNEE FIBERTAK",
      "code_information": [
        {
          "code": "SUP-AR-3770SP",
          "type": "CDM"
        },
        {
          "code": "C1713",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1665,
          "discounted_cash": 1082.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1067.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1215.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1015.65
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1415.25
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1380.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1365.3
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1365.3
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1272.06
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1015.65
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1415.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1090.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1015.65
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 454.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1365.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1346.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1067.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1215.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1015.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1083.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1090.58
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1248.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1272.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 915.75
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1365.3
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1415.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1215.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1063.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1063.94
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 924.08
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 915.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1067.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1067.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1272.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1090.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1067.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1272.06
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1415.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1415.25
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 915.75
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1415.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 924.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1067.27
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 915.75
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1380.29
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1365.3
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1665
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1067.27
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1415.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1090.58
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1415.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1015.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1015.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1098.9
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 924.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1015.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1083.92
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 1082.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1090.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1460.21
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 21.9,
              "estimated_amount": 364.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1067.27
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1215.45
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1365.3
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1460.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 924.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1365.3
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1346.99
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1215.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1015.65
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1415.25
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1415.25
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1415.25
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1248.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1415.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1015.65
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1415.25
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1415.25
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1067.27
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1015.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1067.27
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1248.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1015.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1083.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1090.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 915.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1067.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1063.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 1063.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1083.92
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1380.29
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1465.2
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1272.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 915.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1083.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1365.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1015.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 1015.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1215.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 915.75
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 1067.27
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1090.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 1090.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1272.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1665,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "GRAFT 10M X 20CM KNITTED STR INTERGARD",
      "code_information": [
        {
          "code": "SUP-IGK0010-20",
          "type": "CDM"
        },
        {
          "code": "C1768",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 908.31,
          "discounted_cash": 590.4,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 693.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 693.95
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 554.07
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 772.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 582.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 582.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 663.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 594.94
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 772.06
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 772.06
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 681.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 594.94
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 554.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 591.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 744.81
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 772.06
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 582.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 582.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 663.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 908.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 554.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 582.23
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 772.06
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 772.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 504.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 554.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 591.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 591.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 734.82
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 554.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 554.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 693.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 693.95
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 663.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 580.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 594.94
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 796.59
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 744.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 554.07
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 772.06
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 799.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 582.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 663.07
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 504.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 591.31
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 247.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 582.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 663.07
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 752.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 752.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 580.41
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 594.94
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 504.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 554.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 580.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 744.81
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 499.57
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 594.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 693.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 582.23
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 772.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 663.07
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 772.06
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 772.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 554.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 734.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 504.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 554.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 744.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 554.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 591.31
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 681.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 693.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 582.23
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 594.94
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 772.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 499.57
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 580.41
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 594.94
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 499.57
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 499.57
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 681.23
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 772.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 554.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 554.07
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 772.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 744.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 594.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 499.57
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 744.81
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 752.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 744.81
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 590.4
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 582.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 582.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 499.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 499.57
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 582.23
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 599.48
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 772.06
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 796.59
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 744.81
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 908.31,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "SHEETING 2 X 3IN SILICONE NON-REINFORCED",
      "code_information": [
        {
          "code": "SUP-PR72034-51N",
          "type": "CDM"
        },
        {
          "code": "C1889",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 276,
          "discounted_cash": 179.4,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 176.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 201.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 168.36
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 234.6
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 276,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 176.92
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 168.36
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 276,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 176.92
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 234.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 180.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 176.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 176.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 153.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 276
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 153.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.32
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 234.6
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 234.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 242.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 242.05
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 234.6
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 276,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 168.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 176.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 168.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 223.28
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 153.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 179.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 201.48
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 180.78
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 180.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 168.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 168.36
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 210.86
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 234.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 168.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 223.28
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.8
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.8
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 234.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 168.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 176.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 210.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 179.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 234.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 168.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 180.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 228.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 168.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 210.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 180.78
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 179.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 179.68
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 201.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 176.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 180.78
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 276,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 151.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 176.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 168.36
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 234.6
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 234.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 207
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 201.48
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 234.6
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 176.92
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 201.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 168.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 61,
              "estimated_amount": 168.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 179.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 180.78
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 207
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 276,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 242.88
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 276,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 210.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 207
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 182.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.9,
              "estimated_amount": 176.36
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.32
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 234.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 176.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 201.48
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 75.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 228.8
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 234.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 210.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 210.86
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 176.92
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 234.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 226.32
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.5,
              "estimated_amount": 180.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 176.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 176.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.1,
              "estimated_amount": 176.92
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 276,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 153.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 228.8
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 179.4
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter 100% Silicone 24 Fr 5 Cc Peco Cardinal",
      "code_information": [
        {
          "code": "PX-CH-PCPF5824",
          "type": "CDM"
        },
        {
          "code": "A4344",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.57,
          "discounted_cash": 4.27,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.45
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.78
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 4.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.28
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 4.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 5.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.61
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 5.32
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.57,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Alginate Ag Melgisorb Ag 1 in X 18 In",
      "code_information": [
        {
          "code": "PX-CH-SM255600",
          "type": "CDM"
        },
        {
          "code": "A6199",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 18.13,
          "discounted_cash": 11.78,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.41
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 11.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.87
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.41
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13.6
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.87
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.46
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.87
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.97
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.41
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.87
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.41
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13.6
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.97
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 15.95
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14.67
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10.06
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.46
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.41
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.8
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 15.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.46
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.87
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.46
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 11.46
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 18.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 13.23
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 15.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 11.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 14.87
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 13.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 15.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 11.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 14.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 10.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 18.13,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "HC Ot Re-Eval",
      "code_information": [
        {
          "code": "PX-43400009",
          "type": "CDM"
        },
        {
          "code": "97168",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 261,
          "discounted_cash": 169.65,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 167.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 261,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 221.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 144.86
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 167.56
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 221.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 190.53
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 211.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 199.4
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 221.85
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 211.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 261,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 261,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 261,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 167.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 228.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 143.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 216.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 216.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 261,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 199.4
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 195.75
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 164.95
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 143.55
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 190.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 199.4
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 69.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 261,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 214.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 143.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 143.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 164.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 169.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 190.53
            },
            {
              "payer_name": "PARAMOUNT MANAGED MEDICAID [554]",
              "plan_name": "PARAMOUNT ADVANTAGE MEDICAID [554400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 261,
              "additional_payer_notes": "ALL OTHER OP"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 261,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 221.85
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 221.85
            },
            {
              "payer_name": "UHC MANAGED MEDICAID [275]",
              "plan_name": "UHC MEDICAID COMMUNITY PLAN [275400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 261,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 172.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 167.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 164.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 144.86
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 169.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 214.02
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 221.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 199.4
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 195.75
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 221.85
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 143.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 143.55
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 169.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 169.91
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 221.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 167.56
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 169.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 214.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 214.02
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 261,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 143.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 144.86
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 221.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 167.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 164.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 167.56
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 195.75
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 261,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 221.85
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            },
            {
              "payer_name": "MOLINA MANAGED MEDICAID [260]",
              "plan_name": "MOLINA MEDICAID OF OHIO [260405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 261,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 214.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 167.56
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 190.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 214.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 261,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 261,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 261,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 261,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 261,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 261,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 164.95
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 144.86
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 216.37
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 214.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 261
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 167.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 164.95
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 221.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 261,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 164.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 167.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 199.4
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 199.4
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 164.95
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 71.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 169.91
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 221.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 221.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 261,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 190.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 261,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 167.56
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 214.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 221.85
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 261,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 167.56
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 228.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 261,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 229.68
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 190.53
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "fee schedule",
              "standard_charge_algorithm": "The highest priced service per service date from the OP Rehab fee schedules is priced at the full fee schedule rate, while all others for that service date are priced at the reduced fee schedule rate.",
              "estimated_amount": 66.65
            }
          ]
        }
      ]
    },
    {
      "description": "Percutaneous Transcatheter Closure of Paravalvular Leak Mitral Valve",
      "code_information": [
        {
          "code": "PX-48000064",
          "type": "CDM"
        },
        {
          "code": "93590",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 16533,
          "discounted_cash": 10746.45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12631.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14499.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13375.2
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13557.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10762.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13557.06
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 10911.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12069.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13557.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9093.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10448.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10448.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9093.15
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12069.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9175.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10448.86
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10448.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9175.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13557.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12399.75
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13705.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12399.75
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 4513.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12631.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 16533,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13705.86
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10762.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 14499.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9093.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10448.86
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 12399.75
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10762.98
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12069.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9175.82
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10448.86
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 13705.86
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 10746.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9093.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13557.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9093.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 13375.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10448.86
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12069.09
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 9175.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12069.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9093.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12631.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 10448.86
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 14549.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 12069.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10762.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 10762.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13557.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13557.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12631.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 16533
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 13557.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12631.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 12631.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 10614.19
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 9093.15
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 16533,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 14053.05
            }
          ]
        }
      ]
    },
    {
      "description": "\"Belt Support Nu-Hope 2-1/4\"\" Ring 32\"\"-35\"\" W\"",
      "code_information": [
        {
          "code": "PX-CH-79BG2666",
          "type": "CDM"
        },
        {
          "code": "A4396",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 64.34,
          "discounted_cash": 41.82,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 42.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.71
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.16
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.71
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 52.05
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.97
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 52.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 35.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 56.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.16
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.16
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.39
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 41.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 41.89
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.39
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.16
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 56.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 49.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.66
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 64.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 53.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 48.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 41.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 46.97
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 54.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.66
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 52.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 35.39
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 17.56
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 56.62
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 40.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 64.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "\"Foam Dressing Kerrafoam 4\"\" X 5\"\" Non-Adhesive\"",
      "code_information": [
        {
          "code": "PX-CH-87CWL1116",
          "type": "CDM"
        },
        {
          "code": "A6210",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 5.81,
          "discounted_cash": 3.78,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.11
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 5.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.59
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 3.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.1
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.67
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.24
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 4.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 4.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.36
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 5.81,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "\"Trach Tube Cuffed 1/2 Mm Size 80 Mm 71/2\"\"Tube\"",
      "code_information": [
        {
          "code": "PX-CH-BJ670175",
          "type": "CDM"
        },
        {
          "code": "A7521",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 228.68,
          "discounted_cash": 148.64,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 174.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 144.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 187.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 174.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.77
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 146.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 148.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 148.87
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 144.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 166.94
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 62.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 166.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 146.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 146.81
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 201.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 187.52
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 171.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 146.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 200.55
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 185
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.38
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 166.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 146.81
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 187.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 200.55
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.77
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 144.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 144.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 189.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 146.81
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.77
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 187.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 187.52
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.38
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 187.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 187.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 146.81
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 171.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 146.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 144.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.77
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 228.68
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 126.92
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 189.58
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 189.58
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 148.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 174.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 146.81
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 166.94
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 146.81
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 185
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.77
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.77
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 166.94
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 187.52
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 144.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 171.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 148.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 174.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 174.71
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.38
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 125.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 144.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 126.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.38
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 126.92
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 166.94
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 148.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 148.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 146.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 126.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 174.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 146.81
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 150.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 144.53
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 228.68,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 194.38
            }
          ]
        }
      ]
    },
    {
      "description": "Wound Wash Saline 3 Oz",
      "code_information": [
        {
          "code": "PX-CH-CAH8553",
          "type": "CDM"
        },
        {
          "code": "A4216",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.34,
          "discounted_cash": 6.72,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.9
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.82
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.76
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.9
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.76
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.07
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.48
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.76
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.07
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.55
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.82
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.64
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.34
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.34,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.57
            }
          ]
        }
      ]
    },
    {
      "description": "\"Hydrofiber Foam Ag Aquacel 2/5\"\" X 18\"\"\"",
      "code_information": [
        {
          "code": "PX-CH-CV4201-27",
          "type": "CDM"
        },
        {
          "code": "A6199",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 21.91,
          "discounted_cash": 14.24,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.99
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.99
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.26
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 19.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 21.91
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 17.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 15.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.26
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 5.98
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 14.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 18.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 17.73
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 18.62
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.16
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 14.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 16.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 16.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 19.28
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 12.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 12.05
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 13.85
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 14.07
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 19.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 21.91,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Pleurx Drainage Line",
      "code_information": [
        {
          "code": "PX-CH-DB50-7225",
          "type": "CDM"
        },
        {
          "code": "A4649",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 37.61,
          "discounted_cash": 24.45,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.87
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.48
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.48
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.46
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 32.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.73
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.84
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.87
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.84
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 10.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.77
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.84
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.97
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.77
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.43
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 24.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 31.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.73
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 32.98
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.77
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.77
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 30.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 24.82
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 33.1
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 37.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.77
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 28.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 28.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 23.77
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 27.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 20.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 30.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 24.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 37.61,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 20.87
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 31.97
            }
          ]
        }
      ]
    },
    {
      "description": "Absorption Dressing Xtrasorb Non Adhesive 6 in X 9 In",
      "code_information": [
        {
          "code": "PX-CH-DUM89569",
          "type": "CDM"
        },
        {
          "code": "A6253",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.72,
          "discounted_cash": 5.67,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.72
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.37
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.37
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.54
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.23
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.23
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.54
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.65
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.23
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.76
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.8
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.54
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.38
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.84
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.66
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.05
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.6
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.68
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.37
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.37
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.15
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.67
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.72,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.41
            }
          ]
        }
      ]
    },
    {
      "description": "\"2 Pc Ctf Std Wear 2-1/4\"\" Ceraplus Blue\"",
      "code_information": [
        {
          "code": "PX-CH-HO11204",
          "type": "CDM"
        },
        {
          "code": "A4409",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.6,
          "discounted_cash": 6.89,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.81
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.01
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.69
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.81
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.81
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.69
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 9.3
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.01
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.69
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.9
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.58
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.01
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.01
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.9
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.79
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.9
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.01
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.81
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 9.01
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.89
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 9.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.81
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.6
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.88
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.81
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 8.1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.69
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.69
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.81
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.81
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.69
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.95
            }
          ]
        }
      ]
    },
    {
      "description": "\"2 Pc Pouch 2-3/4\"\" New Image Lock-N-Roll\"",
      "code_information": [
        {
          "code": "PX-CH-HO18114",
          "type": "CDM"
        },
        {
          "code": "A5063",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 4.27,
          "discounted_cash": 2.78,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 3.76
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 4.27
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 3.45
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 2.37
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 3.74
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 3.2
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 2.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 3.12
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 3.54
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 3.63
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 3.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 2.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 2.7
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 2.35
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 3.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 4.27,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Alcohol Wipes Large 2.5 in X 3 In",
      "code_information": [
        {
          "code": "PX-CH-ICV360-69900",
          "type": "CDM"
        },
        {
          "code": "A4245",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.05,
          "discounted_cash": 0.03,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.05
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 0.05,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.04
            }
          ]
        }
      ]
    },
    {
      "description": "Adhesive Drsg Sheer 3/4 In",
      "code_information": [
        {
          "code": "PX-CH-KN3065",
          "type": "CDM"
        },
        {
          "code": "A6413",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.03,
          "discounted_cash": 0.02,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.02
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.03,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.02
            }
          ]
        }
      ]
    },
    {
      "description": "Water Sterile 250cc Irrigation",
      "code_information": [
        {
          "code": "PX-CH-OI30-6290",
          "type": "CDM"
        },
        {
          "code": "A4216",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.39,
          "discounted_cash": 1.55,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.56
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.56
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 2.1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.58
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.83
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.79
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.31
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 2.1
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.96
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.56
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 2.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.56
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.74
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.96
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.31
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter Silicone Elastomer 22 Fr 5 Cc Peco Cardinal",
      "code_information": [
        {
          "code": "PX-CH-PCPF6522",
          "type": "CDM"
        },
        {
          "code": "A4338",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.33,
          "discounted_cash": 0.86,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.36
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.1
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.74
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.87
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.02
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.85
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.33,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.13
            }
          ]
        }
      ]
    },
    {
      "description": "Foam Drsg Non-Adhesive Reliamed 6 in X 6 In",
      "code_information": [
        {
          "code": "PX-CH-ZDF66",
          "type": "CDM"
        },
        {
          "code": "A6210",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.08,
          "discounted_cash": 3.95,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.35
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.04
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.04
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.37
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.01
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.34
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.92
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.56
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.84
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.08,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.17
            }
          ]
        }
      ]
    },
    {
      "description": "Presence Pad Super Abs. 4 X 10.75 In",
      "code_information": [
        {
          "code": "PX-CH-KN1110B",
          "type": "CDM"
        },
        {
          "code": "T4535",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.38,
          "discounted_cash": 0.25,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.28
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.1
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.31
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.25
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.29
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.24
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.38,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "1 Pc Ctf Std Wear Cvx 5/8-1 5/16 Sensura Mio",
      "code_information": [
        {
          "code": "PX-CH-CO16738",
          "type": "CDM"
        },
        {
          "code": "A4389",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.45,
          "discounted_cash": 5.49,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.31
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.41
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.84
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.84
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.01
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.69
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.58
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.45
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.5
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.42
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.46
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.65
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.45,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.46
            }
          ]
        }
      ]
    },
    {
      "description": "Plug Catheter With Cap",
      "code_information": [
        {
          "code": "PX-CH-KN1600",
          "type": "CDM"
        },
        {
          "code": "A9270",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.42,
          "discounted_cash": 0.92,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.79
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.94
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.07
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.92
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.42,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Barrier Ring Moldable Brava 4.2 Mm Thickness",
      "code_information": [
        {
          "code": "PX-CH-SW120427",
          "type": "CDM"
        },
        {
          "code": "A4385",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 6.17,
          "discounted_cash": 4.01,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.11
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 5.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 1.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 4.63
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 4.07
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 6.17
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 4.5
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 4.99
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 4.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 5.06
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 3.39
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 3.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 3.96
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 3.42
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 5.11
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 4.02
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 5.24
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 6.17,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "2 Pc Pouch 1 3/4 in Sur-Fit High Output",
      "code_information": [
        {
          "code": "PX-CH-CV4206-95",
          "type": "CDM"
        },
        {
          "code": "A4413",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 10.03,
          "discounted_cash": 6.52,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.32
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.8
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.32
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.32
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.32
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.31
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 10.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.22
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.57
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 8.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.22
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.22
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.62
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.74
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.57
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 8.31
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.22
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.34
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.53
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8.83
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.52
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 8.22
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.32
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.66
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.52
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 10.03,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.53
            }
          ]
        },
        {
          "setting": "outpatient",
          "gross_charge": 9.62,
          "discounted_cash": 6.25,
          "payers_information": [
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.62
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.63
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 6.25
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.89
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.89
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.26
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 6.35
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.89
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.78
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.89
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.26
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.26
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 8.47
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.97
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.78
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 7.22
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.34
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.97
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.89
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 6.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.62,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 8.18
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 6.18
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 6.08
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 5.29
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 7.02
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 7.35
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 8.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.89
            }
          ]
        }
      ]
    },
    {
      "description": "Cardinal Protective Underwear 2xlg",
      "code_information": [
        {
          "code": "PX-CH-IMCUWL30",
          "type": "CDM"
        },
        {
          "code": "T4528",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1.27,
          "discounted_cash": 0.83,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 1.27
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.84
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.35
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 1.12
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 1.11
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.08
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 1.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.8
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.95
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.04
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.83
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.82
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.93
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 1.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Catheter 3-Way Lubricious 18 Fr 30 Cc",
      "code_information": [
        {
          "code": "PX-CH-BA0167L18",
          "type": "CDM"
        },
        {
          "code": "A4346",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 27.23,
          "discounted_cash": 17.7,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.21
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 15.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20.8
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 15.11
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 23.88
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.15
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 17.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 15.11
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 22.57
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 15.11
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 22.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 17.73
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 17.73
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.15
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 20.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.21
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 17.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 23.88
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 17.97
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 20.42
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 22.57
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 17.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20.8
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 22.03
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.15
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.98
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 22.57
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 17.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 20.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 20.42
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 23.96
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 23.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 27.23
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 14.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.21
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 17.48
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 19.88
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 17.21
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 22.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 27.23,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            }
          ]
        }
      ]
    },
    {
      "description": "Leg Bag Conveen Contour 21 Oz",
      "code_information": [
        {
          "code": "PX-CH-CO5170",
          "type": "CDM"
        },
        {
          "code": "A4358",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 8.43,
          "discounted_cash": 5.48,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.82
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.3
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 6.82
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 8.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.56
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.39
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.64
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 6.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.33
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.42
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 4.68
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.41
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 6.99
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.17
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.32
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 8.43,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Belt Ostomy Sensura Mio 61 In",
      "code_information": [
        {
          "code": "PX-CH-CO4247",
          "type": "CDM"
        },
        {
          "code": "A4367",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 9.06,
          "discounted_cash": 5.89,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 2.47
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 9.06
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 7.97
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.92
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.92
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.92
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.92
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 5.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 5.03
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 7.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 5.82
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.92
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 6.61
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 5.73
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 4.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 7.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 6.92
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 5.9
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 6.8
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 7.95
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 7.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 9.06,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 7.7
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 5.89
            }
          ]
        }
      ]
    },
    {
      "description": "Mask Earloop Cardinal Health",
      "code_information": [
        {
          "code": "PX-CH-55AT7511",
          "type": "CDM"
        },
        {
          "code": "A4928",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 0.6,
          "discounted_cash": 0.39,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 0.6
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 0.53
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 0.4
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICAID [255]",
              "plan_name": "CARESOURCE MEDICAID [255400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA/PPO/POS/HMO-NON CHOICE CARE NTWK [465210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 0.5
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 0.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 0.33
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 0.38
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 0.6,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 0.44
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 0.39
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 0.49
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 0.45
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 0.51
            }
          ]
        }
      ]
    },
    {
      "description": "Matrix Drsg Collagen 19.1 Sq in Promogran",
      "code_information": [
        {
          "code": "PX-CH-JJPG019",
          "type": "CDM"
        },
        {
          "code": "A6022",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 49.39,
          "discounted_cash": 32.1,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.73
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 27.41
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 37.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.71
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR GOLD PLUS HMO [464300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 32.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 31.21
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.98
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 27.41
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 32.15
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 43.32
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.98
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 27.16
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.98
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 32.15
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 27.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 36.05
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 49.39
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 39.96
            },
            {
              "payer_name": "CARESOURCE MANAGED MEDICARE [254]",
              "plan_name": "CARESOURCE ADVANTAGE [254300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 31.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 31.21
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 27.16
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 27.41
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 31.21
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 32.6
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 27.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.71
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.5
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.5
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 40.94
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 39.96
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 32.15
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 27.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.73
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.73
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 31.21
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 43.32
            },
            {
              "payer_name": "HUMANA MANAGED MEDICARE [464]",
              "plan_name": "HUMANA MCR ADVANTAGE CHOICE PPO [464310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.73
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 13.48
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.98
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.98
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 27.41
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE HMO [486110]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.5
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 31.21
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.71
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.98
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.98
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.71
            },
            {
              "payer_name": "THE HEALTH PLAN [265]",
              "plan_name": "THE HEALTH PLAN HMO PPO MEDICARE ADV [265100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 27.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 40.94
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 37.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.71
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 41.98
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.71
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA MEDICARE COMPLETE/CHOICE CARE [264300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.5
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MYCARE OHIO MCR AND MCD [314310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 36.05
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 36.05
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 40.94
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.73
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 37.04
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 31.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 31.21
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 37.73
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 27.16
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 36.05
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 32.15
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 31.21
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 36.05
            },
            {
              "payer_name": "MMO MANAGED MEDICARE [486]",
              "plan_name": "MMO MANAGED MEDICARE PPO [486100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 40.5
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 36.05
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 43.46
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (HMO) [314300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 49.39,
              "additional_payer_notes": "OPPS APC"
            }
          ]
        }
      ]
    },
    {
      "description": "Wound Cleanser Dakin's 25% Sol 16 0z",
      "code_information": [
        {
          "code": "PX-CH-CK0436093616",
          "type": "CDM"
        },
        {
          "code": "A6260",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 20.11,
          "discounted_cash": 13.07,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK OPEN ACCESS [443205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM FEDERAL GOVT [335205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO HEALTH CHOICE PLAN (OHCP) [535200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC POS/EPO [625220]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/RIVER VALLEY CHOICE PLUS [625265]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "CENPATICO [280400]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "BUCKEYE MANAGED MEDICARE [285]",
              "plan_name": "ALLWELL BUCKEYE HEALTH PLAN MEDICARE ADV [285100]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA HMO/NTWK/OACCESS/OA+/POS [370225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHCP MEDBEN [535205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC PPO OHC [553305]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.68
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTH SMART [493205]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 20.11
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.49
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AULTCARE HEALTHREACH [540405]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.68
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 13.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.09
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE ADVANTAGE OHC [553225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.68
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CHOICE [553315]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.68
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA TPA* [370230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 16.27
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.09
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "OHIO PPO CONNECT [535225]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/HERITAGE PLUS [625295]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "TRUSTMARK/CORESOURCE OHCP [535345]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA SIGNATURE PPO*/TPA [310202]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "NIPPON AETNA [310330]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST CONSUMER ADVANTAGE* [550210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16.67
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO MANSFIELD CITY SCHOOLS [485250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MUTUAL HEALTH SERVICES MMO [485260]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.09
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
              "plan_name": "INHEALTH MUTUAL PPO [494200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 15.08
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED CLASSIC [485205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA TRADITIONAL CHOICE INDEMNIT [310245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ACCESS/ENHANCED/CORE PPO/RPPO [334305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "BCBS OUT OF STATE MISC [335690]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "SEORMC MEDBEN [535350]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.49
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OPTIONS PPO [625210]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH OH [540410]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC CHOICE [625225]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "COVENTRY [406]",
              "plan_name": "COVENTRY HEALTH NETWORK* [406200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "SRC/AETNA AFF HEALTH CH/PPO INDEM [310270]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HMO QPOS/SELECT [310215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK AETNA [310335]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA CHOICE POS/POSII/PREMIER CARE/PREMIER CARE PLUS [310205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "GENERAL AMERICAN LIFE OHCP [535220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.49
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH EBSC [540420]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BLUE/PREF/HMO/PPO [335230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "GREAT WEST HEALTHCARE PPO [550205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16.67
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO ACCESS/TPA [485230]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 17.64
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "COFINITY [407]",
              "plan_name": "COFINITY* [407200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "OHIO PREFERRED NETWORK [546]",
              "plan_name": "ZELIS NETWORK SOLUTIONS STRATOSE* [546200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 88,
              "estimated_amount": 17.7
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 5.49
            },
            {
              "payer_name": "FIRST HEALTH [408]",
              "plan_name": "FIRST HEALTH* [408200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT MEIJER STEPS2HEALTH [555210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESSENTIAL/PLUS/CONNECT/SNP HMO [334300]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "FLORA [411]",
              "plan_name": "FLORA HEALTH NETWORK* [411200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "AULTCARE-HEALTHSMART [493215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC AARP MEDICARE COMPLETE [624335]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.36
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.36
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA BEHAVIORAL HEALTH [370200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 13.09
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.68
            },
            {
              "payer_name": "GREATWEST [550]",
              "plan_name": "CIGNA SELECT/GREAT WEST HEALTH [550200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82.9,
              "estimated_amount": 16.67
            },
            {
              "payer_name": "HUMANA [465]",
              "plan_name": "HUMANA-ONLY CHOICE CARE NTWK [465200]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH NETWORK OPTION [310290]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS ELECT CHOICE [310200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 12.91
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 17.09
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "MIDWEST HEALTH/PARAMOUNT EMP ONLY PROMED [540400]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 11.06
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC TPA/SHARED SERVICES* [625275]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "ANTHEM MANAGED MEDICARE [334]",
              "plan_name": "ANTHEM MEDIBLUE ESS HMO COPC SENIOR CARE [334310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "AULTCARE PPO CONNECT [535355]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 16.49
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL OF OH TRADITIONAL [485200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 87.7,
              "estimated_amount": 17.64
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 11.16
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "HEALTHSCOPE AETNA [310320]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 15.36
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 12.71
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 16.27
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC NAVIGATE [625280]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 20.11,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU OUT OF AREA OHC [553310]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 14.68
            }
          ]
        }
      ]
    },
    {
      "description": "Connector 5 in 1",
      "code_information": [
        {
          "code": "PX-CH-PH350A",
          "type": "CDM"
        },
        {
          "code": "A4649",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 2.27,
          "discounted_cash": 1.48,
          "payers_information": [
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OSU STUDENT HEALTH INSRNCE [310206]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTH FUND [310250]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UNITEDHEALTHCARE DUAL COMPLETE (HMO SNP) [624315]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH* [540240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "HEALTHPARTNERS CIGNA [370240]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA PPO/EPO/FUNDAMENTAL CARE [370210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 80.9,
              "estimated_amount": 1.84
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR CHOICE PLUS [625250]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "HEALTHLINK [443]",
              "plan_name": "HEALTH LINK PPO [443200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 75,
              "estimated_amount": 1.7
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "TRUSTMARK/CORESOURCE AETNA [310340]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 76.4,
              "estimated_amount": 1.73
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "MVP CIGNA [370425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "CIGNA [370]",
              "plan_name": "CIGNA CHOICE FUND-ANY CHOICE FUND [370220]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 65.1,
              "estimated_amount": 1.48
            },
            {
              "payer_name": "OHIO HEALTH CHOICE [535]",
              "plan_name": "FRONTPATH HEALTH COALITION OHCP [535215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 82,
              "estimated_amount": 1.86
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC HMO/CHOICE PLUS/SEL/SEL PLUS [625205]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED PPO [485210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "MOLINA MANAGED MEDICARE [264]",
              "plan_name": "MOLINA DUAL OPTIONS MYCAREOHIO [264305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MEDICAL MUTUAL SUPERMED SEL POS [485215]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC STUDENT RESOURCES [625255]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "HEALTHSCOPE UHC WHIRLPOOL [625340]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC GEHA [625285]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "MERITAIN AETNA [310325]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN CHOICE PPO [310210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MMO SUPERMED PPO STATE OF OH [485255]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "SEORMC [545]",
              "plan_name": "SEORMC MEDBEN [545100]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 66,
              "estimated_amount": 1.5
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "AVALON HEALTHREACH WV [540415]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU BASIC OUT OF AREA OHC [553300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OXFORD [625260]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "BUCKEYE COMMUNITY PLAN [280]",
              "plan_name": "BUCKEYE MEDICAID COMMUNITY HEALTH PLAN [280405]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid as a percent of APC rate.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "OUTPATIENT"
            },
            {
              "payer_name": "EMERALD [395]",
              "plan_name": "EMERALD HEALTH NETWORK (PPO)* [395205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA HEALTHREACH PREFERRED [310203]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "AETNA [310]",
              "plan_name": "AETNA OPEN ACCESS MANAGED CHOICE [310201]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 64.2,
              "estimated_amount": 1.46
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "UPMC MMO [485245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "HEALTHSMART [493]",
              "plan_name": "HEALTHSMART OSU STUDENT (IN FRANKLIN CO) [493210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC/GOLDEN RULE [625270]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE HMO/HMO-POS [624305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "AHPO [305]",
              "plan_name": "AHPO (ACCNTBL HEALTH PLAN OF OH) [305200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "OSU [553]",
              "plan_name": "OSU PRIME CARE CONNECT OHC [553245]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 73,
              "estimated_amount": 1.66
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM DIRECTACCESS BLUE (JWQ/JWJ) [335300]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55.5,
              "estimated_amount": 1.26
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OHIO UNIVERSITY STUDENT RESOURCES [625300]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE HMO [555200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "UHC MANAGED MEDICARE [624]",
              "plan_name": "UHC MEDICARE PPO [624310]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "PARAMOUNT [555]",
              "plan_name": "PARAMOUNT HEALTHCARE PPO [555205]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "MMO [485]",
              "plan_name": "MED MUTUAL SUPERMED HMO [485235]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 63.2,
              "estimated_amount": 1.43
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC OSU STUDENT RESOURCES [625290]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "AETNA MANAGED MEDICARE [314]",
              "plan_name": "AETNA MEDICARE PLAN (PPO) [314305]",
              "methodology": "other",
              "standard_charge_algorithm": "Paid using APC or APG reimbursement logic. Includes reimbursement for any outliers.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "OPPS APC"
            },
            {
              "payer_name": "HEALTHREACH [540]",
              "plan_name": "HEALTHREACH MEDBEN [540425]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 55,
              "estimated_amount": 1.25
            },
            {
              "payer_name": "ANTHEM [335]",
              "plan_name": "ANTHEM BC TRADITIONAL [335200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 100,
              "estimated_amount": 2.27
            },
            {
              "payer_name": "OHIOHEALTHY MEDICAL PLAN [556]",
              "plan_name": "GENESIS HC SYSTEM-OHHEALTHYNETWORK [556210]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 27.3,
              "estimated_amount": 0.62
            },
            {
              "payer_name": "UHC [625]",
              "plan_name": "UHC UMR OPTIONS [625335]",
              "methodology": "other",
              "standard_charge_algorithm": "Service paid by fee schedule.",
              "estimated_amount": 2.27,
              "additional_payer_notes": "LAB FEE SCHEDULE"
            },
            {
              "payer_name": "IHG [492]",
              "plan_name": "INTERPLAN HEALTH GROUP (IHG)* [492200]",
              "methodology": "percent of total billed charges",
              "standard_charge_percentage": 85,
              "estimated_amount": 1.93
            },
            {
              "payer_name": "INHEALTH MUTUAL [494]",
        